Medicare Supplement

Before You Apply: How to Compare Medigap in St. Louis

St. Louis, Mo. — If you have looked at Medicare Supplement (Medigap) coverage in Missouri, you have probably noticed something confusing: the same plan letter is sold by a long list of insurers, and each one charges its own premium. The coverage itself is identical by law. So what actually differs from one company to the next? Mostly three things: how the insurer prices the policy, how often it has raised rates in the past, and whether it offers household discounts or applies medical underwriting.

Medicare SupplementSt. Louis, MO

St. Louis sits inside the City of St. Louis, an independent city that Medicare treats as its own county for plan availability. The Missouri insurers listed below sell to residents there.

The same plan letter is the same coverage

Medigap plans are standardized by federal law. That means Plan G from one company pays the same benefits as Plan G from another. Plan N is Plan N everywhere. This is important because it lets you compare apples to apples: once you pick the letter you want, you are really just shopping for a price and a company you trust to be around and to service the policy.

People new to Medicare today can choose from 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.

The table below lists every insurer selling Medigap in Missouri and which plan letters each one offers.

Who sells Medigap in Missouri

The Missouri Department of Commerce and Insurance and Medicare.gov both track the insurers approved to sell Medigap in the state. As of the most recent Missouri rate data, that list includes AARP - UnitedHealthcare Insurance Company, Aetna Health and Life Insurance Company, AFLAC, Bankers Life (underwritten by Washington National Insurance Company), Blue Cross and Blue Shield of Kansas City, HealthSpring National Health Insurance Company, Humana (Humana Insurance Company), Insurance Company of North America, LifeShield National Insurance Company, Lumos Insurance, Medico Life and Health Insurance Company, Mutual of Omaha (United World Life Insurance Company), Old Surety Life Insurance Company, Physicians Life Insurance Company, State Farm Mutual Automobile Insurance Company, United American Insurance Company, USAA Life Insurance Company, and Wisconsin Physicians Service Insurance Corporation.

Not every company sells every plan letter — for example, some sell only a handful of letters while others sell most of them. The full breakdown is in the table on this page.

The three ways insurers price the same plan

When you compare quotes, ask how the insurer prices its policies. There are three common methods, and they change how your premium behaves as you age.

• Attained-age rated. The premium starts lower at 65 and goes up as you get older, on top of any general rate increases. This is the most common method.
• Issue-age rated. Your premium is based on the age you were when you bought the policy. It will not go up just because you have a birthday, though the company can still raise rates across the board.
• Community rated. Everyone in Missouri who has that policy pays the same base premium regardless of age. Younger buyers pay more than they would under attained-age, older buyers less.

None of these methods is automatically better. What matters is how the premium is likely to look five, ten and fifteen years from now, not just this year.

Rate history, household discounts and underwriting

Two policies with the same letter and a similar starting price can drift apart over time if one insurer raises rates more often. Missouri publishes rate history in its Medicare Supplement Insurance Shopper's Guide, and you can ask any agent to show you an insurer's recent Missouri rate change history in writing.

Household discounts. Many Missouri Medigap insurers offer a household or spousal discount — often when two adults in the same home each have a policy, and sometimes just for living with another adult. The size and the rules vary by company, so ask.

Medical underwriting. During your one-time Medigap Open Enrollment Period — the six months starting the month you are 65 and enrolled in Part B — Missouri insurers must sell you any Medigap policy they offer, at their best available rate, regardless of health. Outside that window, and outside a few guaranteed-issue situations, insurers can ask health questions and decline you or charge more. That is why timing your application matters as much as choosing a company.

How to compare quotes without getting lost

A simple way to shop:

1. Pick the plan letter you want first. Compare benefit charts on Medicare.gov before you look at any prices. 2. Pull the list of Missouri insurers selling that letter from Medicare.gov's Medigap policy search (enter your ZIP code). 3. Ask each quote source for: the pricing method, the rate change history in Missouri for the last several years, and any household discount you may qualify for. 4. Confirm whether you are inside your Medigap Open Enrollment Period or a guaranteed-issue situation. If not, ask what the underwriting questions look like before you apply.