Medicare Supplement

Same Medigap Plan G in Santa Rosa: how 15 California insurers actually differ

If you live in Santa Rosa and you're shopping for a Medicare Supplement policy, here is something that surprises a lot of new enrollees: a Plan G is a Plan G, no matter which company sells it. The federal government standardized these letters years ago. What changes from insurer to insurer is not the coverage — it's how the company prices the policy, how often it raises rates, whether it offers a household discount, and how hard it is to switch later. Santa Rosa is in Sonoma County, and Californians have a fairly deep bench of insurers to choose from. Here is how to line them up fairly.

The coverage is the same — the price structure is not

Federal rules require every Medigap insurer to sell the exact same benefits under each plan letter. A Plan G from one carrier pays the same Part A and Part B cost-sharing as a Plan G from any other carrier. There is no "better" version of the same letter.

Where insurers compete is on price and on how that price changes over time. In California, insurers use one of three pricing methods:

• Attained-age rated. The premium is based on your current age and goes up as you get older. It often looks cheap at 65 and climbs from there.
• Issue-age rated. The premium is based on the age you were when you bought the policy. It still rises with inflation and claims, but not because you are getting older.
• Community rated. Everyone in the same area pays the same premium regardless of age.

None of these is automatically the best deal. What matters is how the price behaves across the years you plan to hold the policy.

The insurers selling Medigap in California

The table below lists every company currently selling Medicare Supplement policies to California residents, along with the plan letters each one offers. In alphabetical order, they are: 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, some carry Plan A, F, G and N only, while others carry a wider mix that includes high-deductible G, Plan K and Plan L. The table shows exactly which letters each company offers.

Rate history matters as much as today's premium

A Medigap policy is something most people keep for years. Two insurers can quote similar premiums today but raise rates on very different schedules. California's Department of Insurance publishes rate history guides that show how much each carrier has raised premiums on existing policyholders in recent years. That is the number to look at — not the introductory quote.

When you compare the same plan letter (say, Plan G) across two carriers, ask:

• How has this company raised rates on this plan letter over the past three to five years?
• Is the pricing attained-age, issue-age, or community-rated?
• Are the current rates for people my age already close to the top of the market, or the bottom?

Household discounts and underwriting

Many California Medigap insurers offer a household discount — a percentage off the premium if you live with another adult (a spouse, a domestic partner, sometimes any adult in the home). The size of the discount and the rules for qualifying are set by each insurer, not by Medicare. It is worth asking about, because it applies for the life of the policy.

Underwriting is the other big variable. During your Medigap Open Enrollment Period — the six months starting the month you turn 65 and are enrolled in Part B — insurers must sell you any policy they offer at their standard rate. You cannot be turned down for health reasons. Outside that window, unless you qualify for a guaranteed-issue right, insurers in California can ask health questions and decline you. That makes the first six months especially important.

California also has a "birthday rule" that lets existing Medigap policyholders switch to an equal or lesser plan with the same or another carrier around their birthday each year, without medical underwriting. It is a helpful safety valve if a carrier's rate increases outpace the market.

How to compare the same letter, step by step

1. Pick the plan letter you want. Plans available to people newly eligible today include A, B, D, G, high-deductible G, K, L, M and N. Plans C and F are only for people eligible before January 1, 2020. 2. Use the Medigap policy search at medicare.gov, enter your ZIP code, and pull up every insurer selling that letter in Sonoma County. 3. Note the pricing method for each carrier. 4. Ask each insurer (or an independent agent) about household discounts and rate-increase history. 5. Check the California Department of Insurance rate guide for that plan letter.

Once you have those pieces side by side, the differences between carriers become much easier to see.