Medicare Supplement

Same Medigap letter, different insurer: how to compare your options in Ontario

Ontario shoppers who have narrowed their Medicare Supplement search down to a single plan letter — say Plan G or Plan N — often hit the same wall: more than a dozen insurance companies sell that exact same plan in California, and the benefits are identical by law. So what actually differs from one insurer to the next? Mostly three things: how they price the plan, how their rates have moved over time, and what they ask of you if you apply outside a guaranteed-issue window.

Ontario is in San Bernardino County, where California residents can choose among the standardized Medigap plans set by federal law. Because the coverage inside each lettered plan is the same everywhere, the smart comparison is not "which Plan G is better" — it's how each insurer builds and adjusts the price behind that letter.

The plan letter is the coverage — the insurer is the price

Under federal rules, every Medigap plan sold today with the same letter has the same standardized benefits. A Plan G is a Plan G. A Plan N is a Plan N. If one insurer's Plan G paid a Part B coinsurance and another's didn't, that would be illegal.

For people newly eligible for Medicare, the letters available are A, B, D, G, G-High Deductible, K, L, M and N. Plans C and F are only available to people who were eligible for Medicare before January 1, 2020.

That means when you compare insurers on the same letter, you are really comparing price, pricing method, and service — not benefits.

The insurers selling Medigap in California

The table below lists every insurer currently selling Medigap policies in California and which plan letters each one offers. Names, in alphabetical order as listed by Medicare.gov:

AARP – UnitedHealthcare Insurance Company; AFLAC; American Retirement Life Insurance Company (CIGNA); Anthem BlueCross – California; Bankers Life (underwritten by Washington National Insurance Company); Blue Shield of California Life & Health Insurance Company; Continental Life Insurance Company of Brentwood, Tennessee (Aetna); Everence Association Inc.; Humana (Humana Insurance Company); Insurance Company of North America; Lumos Insurance; Mutual of Omaha (United World Life Insurance Company); State Farm Mutual Automobile Insurance Company; United American Insurance Company; and USAA Life Insurance Company.

Not every insurer sells every letter. For example, AFLAC, Blue Shield of California Life & Health, Everence, Lumos and USAA sell Plans A, F, G and N. Humana and United American offer the widest range of letters. The table below shows the exact mix for each company.

The three pricing methods — and why they matter years from now

Insurers in California can price the same plan letter in one of three ways. This is the single biggest thing that changes how much you pay over time.

Attained-age rated. Your premium is based on your current age and generally goes up as you get older, on top of any general rate increases. It often starts lower at 65 and climbs.

Issue-age rated. Your premium is based on the age you were when you first bought the policy. It doesn't go up just because you had a birthday, though it can still rise with general rate increases.

Community rated (also called no-age-rated). Everyone with the same policy in the same area pays roughly the same, regardless of age. It usually starts higher at 65 but doesn't climb with age.

None of these is universally "better" — the right fit depends on how long you plan to keep the policy and your budget now versus later. Ask each insurer, in writing, which method they use for the letter you're considering.

Rate history, household discounts and underwriting

Two other things vary quietly between insurers:

Rate history. Even with the same pricing method, some carriers raise their rates more often, or more steeply, than others. The California Department of Insurance publishes a Medicare Supplement rate guide that shows historical rate changes by company. It's one of the most useful documents most shoppers have never seen.

Household or spousal discounts. Several insurers offer a percentage discount if a spouse, domestic partner, or in some cases another adult in the household is also enrolled. The size of the discount and who qualifies varies quite a bit — always ask.

Medical underwriting. This is the big one. During your six-month Medigap Open Enrollment Period — which starts the month your Part B begins at age 65 or older — insurers must sell you any Medigap plan they offer, at their best available rate, with no health questions. Outside that window (and outside a few guaranteed-issue situations), insurers can ask about your health and can decline to cover you or charge more.

California has an extra protection called the "birthday rule." Each year, around your birthday, you have a 60-day window to switch to an equal or lesser Medigap plan with the same or different insurer without medical underwriting. That makes it much easier to shop across insurers year after year.

How to compare, step by step

1. Decide which plan letter fits your budget and how you use care. 2. Go to Medicare.gov and use the Medigap policy search for your ZIP code. It lists every insurer selling that letter in Ontario. 3. Pull the California Department of Insurance Medicare Supplement rate guide and look up recent rate changes for each insurer on your short list. 4. Call the insurers (or a licensed agent who represents several of them) and ask three questions: What pricing method do you use? What household discounts apply? What underwriting will I face given my situation? 5. Confirm the plan letter is written exactly the same way on every quote you compare.

Where to get unbiased help

For personalized help that isn't tied to any one insurer, contact California's State Health Insurance Assistance Program — known here as HICAP — which offers free Medicare counseling. You can also call 1-800-MEDICARE or visit medicare.gov for the official Medigap policy search.