Medicare Supplement

Same Plan G, different insurer: what actually changes

Port St. Lucie, Florida — If you have been shopping Medigap in Port St. Lucie and wondering why the same plan letter looks so different from one insurer to the next, you are asking the right question. The coverage is the same. The company behind it is not.

Medicare SupplementPort St. Lucie, FL

Port St. Lucie is in St. Lucie County, where Florida seniors can buy standardized Medigap policies from a long list of insurers. Federal rules lock the benefits of each lettered plan in place, so a Plan G from one company pays the same medical bills as a Plan G from another. What changes is how the insurer prices the policy, how it raises rates over time, whether it offers a household discount, and how strictly it underwrites you if you are switching outside a protected window.

The plan letter is standardized. The company is not.

Medigap plans are standardized by federal law. That means Plan G, Plan N, Plan K and the other letters cover the same things at every insurer licensed to sell them. If Plan G at Company A pays your Part B coinsurance, so does Plan G at Company B.

What insurers can compete on:

• The premium they charge for that plan
• The pricing method they use (more on this below)
• How often and how much they raise rates
• Whether they offer discounts (household, non-tobacco, paperless billing)
• How they underwrite applicants who are not in a guaranteed-issue window

People newly eligible for Medicare today can buy Plans A, B, D, G, G-HD, K, L, M and N. Plans C and F are only available to people who were eligible for Medicare before January 1, 2020.

Who sells Medigap in Florida

Florida seniors have a wide slate of insurers to choose from. The table below lists every insurer and the plan letters each one sells in the state. Names appear alphabetically, and no ranking or recommendation is implied:

AARP - UnitedHealthcare Insurance Company; AFLAC; American Benefit Life Insurance Company; Bankers Life (Underwritten by Washington National Insurance Company); Continental Life Insurance Company of Brentwood, Tennessee (Aetna); Everence Association Inc.; Florida Blue; GPM Health and Life Insurance Company; HealthSpring National Health Insurance Company; Humana (Humana Insurance Company); Humana Achieve (CompBenefits Insurance Company); Insurance Company of North America; LifeShield National Insurance Company; Lumos Insurance; Medico Insurance Company; Mutual of Omaha (United World Life Insurance Company); New Era Life Insurance Company; Physicians Life Insurance Company; SilverScript Insurance Company; State Farm Mutual Automobile Insurance Company; United American Insurance Company; USAA Life Insurance Company; Wisconsin Physicians Service Insurance Corporation; WoodmenLife.

Not every insurer sells every letter. If you want Plan G specifically, for example, most of the companies above offer it, but a handful do not. Florida Blue offers one of the broader menus of plan letters in the state; several insurers focus on a shorter list such as A, F, G and N.

The three pricing methods — and why they matter

This is the single biggest thing that separates one insurer from another on the same plan letter.

Attained-age rated. The premium is based on your current age and goes up as you get older. It often looks lower at 65 and climbs from there. Many Florida Medigap policies are priced this way.

Issue-age rated. The premium is based on the age you were when you bought the policy. It does not go up just because you have another birthday, though it can still increase due to inflation and overall rate hikes.

Community-rated (no-age-rated). Everyone who buys the policy pays the same base rate regardless of age. Fewer insurers use this method, but it exists.

None of these methods is automatically "better." What matters is the total cost over the years you expect to hold the policy. An attained-age policy may look easier to afford at 65 and get harder at 80; an issue-age or community-rated policy may start higher but rise more slowly with age.

Rate history, household discounts and underwriting

Two more things worth checking before you sign an application:

Rate history. Ask each insurer, or check the Florida Office of Insurance Regulation's rate filings, for the past several years of premium increases on the plan letter you want. Two insurers can start at similar prices and end up far apart after a few years of different rate actions.

Household discount. Some insurers reduce the premium if a spouse or another adult in your household also has a policy with them — or, at some companies, simply lives with another Medicare-age adult. The size of the discount and the rules for qualifying vary. Always ask.

Medical underwriting. During your six-month Medigap Open Enrollment Period (which starts the month you are 65 or older and enrolled in Part B), insurers must sell you any Medigap plan they offer, at their standard rate, regardless of health. Outside that window — and outside a handful of guaranteed-issue situations — insurers in Florida can ask health questions and turn you down or charge more. Underwriting rules are set by each insurer, so a person who is declined by one company may be accepted by another.

How to compare, step by step

1. Decide which plan letter fits your needs (a SHIP counselor can help with this). 2. Pull the list of insurers selling that letter in your ZIP code using the Medicare.gov Medigap policy search. 3. For each insurer, note the pricing method, household discount, and rate-increase history. 4. If you are outside a guaranteed-issue window, ask about underwriting before you apply. 5. Compare quotes for the exact same plan letter across at least three insurers.

Because the benefits are identical, comparing the same letter across companies is one of the cleaner shopping exercises in Medicare — you truly are comparing apples to apples on coverage.