Medicare Supplement

Before You Enroll in Medigap, Compare These 4 Things

If you live in Baltimore and you are shopping for a Medicare Supplement policy — better known as Medigap — one thing can save you a lot of second-guessing: the plan letters are standardized. A Plan G sold by one insurer covers the same things as a Plan G sold by any other insurer in Maryland. The coverage is set by federal rules. What changes from company to company is the price, how that price is calculated, how often it goes up, and whether you can get in without medical questions.

Here is how to line up the same plan letter across insurers in Baltimore, which is in Baltimore city, and compare them on the things that actually differ.

The plan letter is the coverage — the insurer is everything else

Medigap plans are standardized by the federal government. If you are newly eligible for Medicare today in Maryland, you can choose from Plans A, B, D, G, high-deductible G, 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 two Baltimore insurers both sell Plan G, the benefits inside that Plan G are identical. One does not have a "better" Plan G than another. What differs is the company behind it.

So instead of comparing benefits, you are really comparing four things: pricing method, rate history, discounts, and underwriting.

Pricing method: how your premium is set

Medigap insurers in Maryland can use one of three pricing methods. This matters because it shapes how your premium behaves as you age.

• Attained-age rated. The premium 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 premium is based on the age you were when you first bought the policy. It does not 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 who has the policy pays roughly the same premium regardless of age. It can still rise with general rate increases.

A policy that looks affordable at 65 under attained-age rating may cost more at 75 than an issue-age or community-rated policy that started at a higher number. Ask each insurer, in writing, which method they use for the plan letter you are considering.

Rate history: what past increases can tell you

Every Medigap insurer files rate changes with the Maryland Insurance Administration. Looking at an insurer's rate-increase history over the last several years is one of the more useful signals you can get, because it hints at how stable your premium may be.

The Maryland Insurance Administration publishes a Medigap rate guide that lists insurers selling in the state and information you can use to compare them. It will not predict the future, but a company with a pattern of steady, moderate increases is telling you something different than one with larger swings.

Household discounts and other price adjustments

Many Medigap insurers in Maryland offer a household discount — a percentage off the premium if you live with another adult, or if your spouse or partner also has a policy with the same company. The rules are not uniform:

• Some insurers require both people to be on a policy with them.
• Some only require that you live with another adult over a certain age.
• The discount percentage varies by insurer.

Ask each company what their household discount is, who qualifies, and whether it applies for the life of the policy.

Underwriting: can you switch later?

This is where the differences between insurers get sharpest.

During your Medigap Open Enrollment Period — the six months that start when you are 65 or older AND enrolled in Part B — insurers in Maryland must sell you any Medigap plan they offer, at their standard price, regardless of your health. This is called guaranteed issue.

Outside that window, insurers can generally use medical underwriting. They can ask health questions and, in most cases, decline coverage or charge more based on your answers. Each insurer sets its own underwriting rules, so one company may accept you when another does not.

If you are already past your Open Enrollment Period, ask each insurer what its underwriting looks like before you apply.

How to find every insurer selling in your ZIP code

You do not have to guess who sells Medigap in Baltimore. Three sources cover it:

1. Medicare.gov Medigap policy search. Enter your ZIP code and see every insurer selling each plan letter in your area. 2. The Maryland Insurance Administration's Medigap rate guide. This is the official state document listing insurers, plan letters, and rating information. 3. Maryland SHIP. Free, unbiased counseling from trained volunteers who can walk you through your options.

The table below lists every plan letter available to new enrollees today. Once you pick the letter, use these three sources to line up the insurers side by side.