Medicare Supplement

Same Medigap letter, different insurer: how Miami shoppers can compare fairly

Medigap shopping in Miami often starts with a simple, confusing question: if Plan G is the same coverage everywhere, why do quotes look so different from one insurer to the next? The short answer is that the letter tells you what the plan covers, but each insurance company sets its own price, its own rate history and its own rules for who can sign up. Miami is in Miami-Dade County, and every insurer licensed to sell Medigap in Florida uses the same standardized plan letters — the differences are in the business behind the letter.

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The letter is the same. The company behind it isn't.

Federal law standardizes Medigap plans by letter. That means Plan N sold by Insurer A pays the same share of Part A and Part B cost-sharing as Plan N sold by Insurer B. Neither company can add or remove benefits from a lettered plan.

What each company can do is decide how to price the plan, how often to raise rates, whether to offer discounts, and — if you're outside a guaranteed-issue window — whether to accept your application based on your health.

The three ways Florida insurers price the same letter

When you compare quotes on the same plan letter, ask the agent or the insurer which pricing method they use. There are three:

• Attained-age rated. The price is based on your current age and generally goes up as you get older, on top of any across-the-board rate increases.
• Issue-age rated. The price is based on your age when you first bought the policy. It doesn't rise just because you had a birthday, though it can still go up for other reasons.
• Community-rated (no-age-rated). Everyone who has the policy pays the same base rate, regardless of age.

None of these methods is automatically cheaper over time. An attained-age policy may look lower at 65 and climb faster later; an issue-age or community-rated policy may start higher but rise more slowly with age. The right comparison is not just today's quote but the shape of the cost over the years you expect to hold the policy.

Rate history matters as much as today's quote

Every Medigap insurer in Florida files rate changes with the state. Two companies selling the same Plan G can have very different track records for how often, and by how much, they've raised premiums on existing customers.

The Florida Office of Insurance Regulation publishes a Medigap rate guide that shows recent increases by company and plan. Your local SHINE counselor can walk you through it. Looking at three to five years of rate history gives you a more honest picture than any single quote.

Household discounts and other differences

Some insurers offer a household discount when two people in the same home each buy a policy — and sometimes when one adult simply lives with another adult, even if that person isn't a customer. The size and rules vary by company. It's worth asking about directly, because it isn't always advertised.

Other things that can differ between insurers selling the same letter:

• Whether they offer a high-deductible version (Plan G-HD is common in Florida).
• Extra perks tied to the policy, such as fitness memberships (these are not part of the standardized letter and can change).
• Payment options and billing.

Underwriting: the rule that changes everything

This is the part many Miami shoppers don't hear about until it's too late. During your six-month Medigap Open Enrollment Period — which starts when you're 65 or older and enrolled in Part B — any insurer selling Medigap in Florida must sell you any plan they offer, at their standard rate, regardless of your health.

Outside that window, and outside specific guaranteed-issue situations, most Florida insurers can use medical underwriting. That means they can ask health questions, look at prescriptions, and decline you or charge more. Two insurers selling the exact same Plan G may have very different underwriting rules — one may accept you, another may not.

Florida also has a "birthday rule" that gives current Medigap policyholders a limited annual window to switch to an equal or lesser plan with the same or a different insurer without new underwriting. The details are specific; SHINE can confirm how it applies to your situation.

How to build a fair, side-by-side comparison

The table on this page lists the standardized plan letters available in Florida. Use it as your starting point, then:

1. Pick the letter that fits the coverage you want (for example, G, G-HD or N). 2. Pull the list of insurers selling that letter in your Miami ZIP code using the Medicare.gov Medigap policy search. 3. Check each insurer's rate history in the Florida OIR Medigap rate guide. 4. Ask each insurer or a licensed agent three questions: What pricing method do you use? Do you offer a household discount? What are the underwriting rules if I apply now? 5. Call SHINE (Florida's SHIP) for a free, unbiased second look before you commit.

Because the coverage is identical letter-for-letter, this kind of apples-to-apples comparison is one of the few places in Medicare where you really can line up quotes without worrying about hidden benefit differences.