Medicare Supplement

Before you pick a Medigap insurer, check these four things

Albuquerque shoppers looking at a Medicare Supplement policy — better known as Medigap — often run into the same confusing question: if Plan G is Plan G, why does one insurer look so different from another? The short answer is that the coverage is identical, but the pricing and rules around it are not. Here is how to compare the same plan letter across insurers in New Mexico without getting lost.

Medicare SupplementAlbuquerque, NM

The plan letter is standardized — the insurer is not

Medigap is federally standardized. That means Plan G sold by one company in Albuquerque pays the exact same share of your Medicare-approved costs as Plan G sold by any other company. The same is true for Plans A, B, D, G-HD (high-deductible G), K, L, M and N. (Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.)

Because coverage is fixed by law, the meaningful differences between insurers come down to four things: how they price the policy, how their rates have changed over time, whether they offer discounts, and how they handle underwriting.

Pricing method: attained-age, issue-age or community-rated

Every Medigap insurer uses one of three pricing methods, and it matters more than most shoppers realize:

• Attained-age rated. The premium is based on your current age and generally goes up as you get older. It often looks cheapest at 65 and rises from there.
• Issue-age rated. The premium is based on the age you were when you bought the policy. It doesn't rise just because you had a birthday, though it can still change with inflation or company-wide adjustments.
• Community-rated. Everyone in the state pays the same base premium regardless of age.

All three can still increase over time due to inflation and claims experience. When you compare two insurers offering the same letter, ask which method each one uses. A policy that looks lower today may not stay that way.

Rate history: what the last few years looked like

A Medigap premium is not locked in. Insurers file rate increases with state regulators, and those increases can vary a lot from company to company. Before committing to a policy, ask the insurer or your agent for the rate-change history over the past five years. The New Mexico Office of the Superintendent of Insurance also publishes a Medigap rate guide that can help you see how carriers have moved rates over time.

A carrier with a steadier rate history may cost more up front but be easier to plan around.

Household discounts and other savings

Many — not all — Medigap insurers offer a "household" or "spousal" discount, typically when two people in the same home each buy a policy from that insurer. The rules vary: some require both spouses to enroll, some only require you to live with another adult, and the discount percentage differs by company. Ask the question directly for every insurer you compare.

Underwriting: when insurers can say no

This is the part that catches people off guard. During your Medigap Open Enrollment Period — the six months that start when you're 65 or older and enrolled in Part B — insurers in New Mexico must sell you any Medigap policy they offer, at their best available rate, regardless of your health.

Outside that window, most insurers can use medical underwriting. That means they can ask health questions, and they can decline your application or charge more based on the answers. A few limited "guaranteed issue" situations still protect you — for example, if your employer coverage ends or a Medicare Advantage plan leaves your area — but they are narrow. If you're thinking about switching Medigap policies later, call the new insurer first and ask what underwriting they'll require.

How to find every insurer selling in Albuquerque

Albuquerque is in Bernalillo County, and Medigap policies are regulated at the state level in New Mexico. To see every insurer that sells a given plan letter in your area:

1. Go to Medicare.gov's Medigap policy search and enter your ZIP code. You'll get a list of every insurer licensed to sell each plan letter locally, along with pricing methods. 2. Check the New Mexico Office of the Superintendent of Insurance for the state's Medigap rate guide. 3. Call New Mexico's SHIP (Senior Health Insurance Assistance) for free, unbiased one-on-one help. SHIP counselors don't sell policies.

The table on this page lists the standardized plan letters available today. Once you pick the letter that fits your budget and coverage preferences, the shopping question becomes: which insurer offers that letter on terms that work for you?