Medicare Supplement

Same Plan G, Different Bill: What Actually Varies

In Kansas City, two neighbors can buy a Medigap Plan G from two different insurers and pay very different premiums for coverage that is, by law, identical. That is not a mistake — it is how the Medigap market is built. The letter tells you the benefits. The insurer's pricing method, rate history, discounts and underwriting rules tell you almost everything else.

Kansas City sits in Jackson County, Missouri, and Missouri residents choose from the standardized Medigap plan letters set by federal law. Here is how to line up the same letter across insurers so you are actually comparing apples to apples.

The letter is the coverage. The insurer is everything else.

Medigap plans are standardized. That means a Plan G from Insurer A pays exactly the same share of your Part A and Part B cost-sharing as a Plan G from Insurer B. The federal government sets what each letter covers.

People newly eligible for Medicare in Missouri today can choose from Plans A, B, D, G, high-deductible G, K, L, M and N. Plans C and F remain available only to people who were eligible for Medicare before January 1, 2020.

Because the benefits are fixed, comparing the same letter across insurers really comes down to four things: how they price it, how their rates have moved, what discounts they offer, and how they handle your health history.

Three ways insurers price the same plan

Missouri allows insurers to use different pricing methods, and each one behaves differently as you age:

• Attained-age rated. The premium is based on your current age and generally rises as you get older, in addition to any across-the-board rate increases.
• Issue-age rated. The premium is based on your age when you first bought the policy and does not go up simply because you had a birthday.
• Community rated. Everyone in the state who has that plan from that insurer pays roughly the same premium, regardless of age.

None of these methods is automatically cheaper. An attained-age policy may look inexpensive at 65 and cost more at 80. A community-rated policy may start higher and stay steadier. When you compare two Plan Gs, ask which method each insurer uses — it changes what "the price" really means over time.

Rate history: the number the ad never shows

Every Medigap insurer raises rates from time to time. Two companies can quote similar premiums today and drift far apart over a decade.

Missouri's Department of Commerce and Insurance publishes a Medigap rate guide that lists insurers licensed in the state and, in many cases, recent rate activity. Reviewing several years of increases tells you more about long-term affordability than any single quote. If a company you are considering has posted repeated large increases, that is worth a conversation before you sign anything.

Household discounts and other price levers

Many insurers in Missouri offer a household or spousal discount — a percentage off the premium when two adults in the same home each hold a policy with that insurer, or in some cases simply when another adult over a certain age lives with you. The size of the discount and the rules to qualify differ by company.

Some carriers also offer a small discount for paying annually or by automatic bank draft. These are legitimate questions to ask each insurer directly, since they can meaningfully change your out-of-pocket premium without changing your coverage.

Underwriting: when the insurer can say no

This is the piece that surprises the most people. During your six-month Medigap Open Enrollment Period — which starts the month your Part B becomes active and you are 65 or older — any insurer selling Medigap in Missouri must sell you any plan they offer, at their best available rate, regardless of your health.

Outside that window, and outside a handful of federal and state guaranteed-issue situations, insurers in Missouri can use medical underwriting. That means they can ask health questions, and they can charge you more or decline to issue the policy. Two insurers can look at the same person and reach different decisions.

If you already have a Medigap policy and are thinking about switching to the same letter at a different company for a better rate, underwriting is the first question to ask.

How to build your own comparison for Kansas City

You do not need to guess who sells what. Three free tools do the work:

1. Medicare.gov Medigap policy search. Enter your Kansas City ZIP code to see every insurer licensed to sell each plan letter in your area, along with the pricing method and sample premiums. 2. Missouri Department of Commerce and Insurance rate guide. The state publishes a Medigap consumer guide that lists licensed insurers and rate information. Search "Missouri Medigap rate guide" on the department's site. 3. CLAIM, Missouri's SHIP. Trained counselors offer free, unbiased help with Medicare questions, including Medigap comparisons. There is no sales pitch and no cost.

The table on this page shows the standardized plan letters available in Missouri so you can see, at a glance, which letters to price out. Pick the letter first, then shop the insurers.