Medicare Supplement

Which Medigap insurers sell in North Carolina, and how to compare the same plan letter across them

If you live in Charlotte and you're shopping for a Medicare Supplement policy, one thing surprises almost everyone: the plan letters are the same at every insurer. A Plan G from one company covers exactly what a Plan G from another company covers. What changes is the price, how that price is set, and how the insurer treats you when you apply. Here's how to line them up fairly.

The plan letter is the coverage — the insurer sets the price

Medigap policies are standardized. If you're newly eligible for Medicare today, you can choose from plan letters A, B, D, G, G-HD, K, L, M and N. (Plans C and F are only for people who became eligible for Medicare before January 1, 2020.)

Every Plan G, for example, covers the same gaps in Original Medicare no matter whose name is on the envelope. That means the smartest way to shop is to pick the letter that fits your budget and health first, then compare that same letter across insurers.

How to find the insurers selling Medigap in Charlotte

Charlotte is in Mecklenburg County, and Medigap availability is set at the state level in North Carolina. There isn't one master public list of every insurer in one place, so use these three sources:

• Medicare.gov Medigap policy search. Enter your ZIP code and the plan letter you want. You'll see the companies licensed to sell that letter to you.
• North Carolina Department of Insurance rate guide. The state publishes a Medigap rate comparison that lists insurers and how their premiums are structured.
• North Carolina SHIIP (the state's SHIP program). Free, unbiased counselors can walk you through the list and answer questions specific to your situation.

The three pricing methods — and why they matter later

When you compare the same plan letter across two insurers, the biggest hidden difference is how the insurer sets your premium. North Carolina insurers may use any of these three methods:

• Attained-age rated. Your premium is based on your current age and generally goes up as you get older, on top of any inflation-related increases.
• Issue-age rated. Your premium is based on the age you were when you bought the policy. It doesn't go up because you get older, but it can still rise due to inflation.
• Community-rated (no-age-rated). Everyone with that policy in the state pays the same base premium, regardless of age.

Two insurers can offer the identical Plan G and price it very differently over 10 or 20 years because of these methods. Always ask which method an insurer uses before you sign.

Rate history, household discounts, and underwriting

Price today isn't the whole story. Three more things separate one insurer's Plan G from another's:

• Rate history. Ask how much the insurer has raised premiums on this plan letter in North Carolina in recent years. The state rate guide and your SHIIP counselor can help you see the pattern.
• Household discounts. Some insurers offer a discount if a spouse or another adult in the home also has a policy with them, or sometimes just lives with you. The rules and the size of the discount vary widely.
• Medical underwriting. During your one-time, six-month Medigap Open Enrollment Period — which starts when you're 65 and enrolled in Part B — insurers must sell you any plan they offer at their standard rate. Outside that window (and outside of specific guaranteed-issue situations), North Carolina insurers can generally ask health questions and decide whether to accept you, charge more, or decline.

Putting it together

A simple side-by-side works well:

1. Pick the plan letter that fits your needs. 2. Pull the list of insurers selling that letter in your ZIP from Medicare.gov. 3. For each insurer, note the pricing method, recent rate changes, any household discount, and whether you're inside your Open Enrollment Period or subject to underwriting. 4. Then — and only then — compare premiums.

The table on this page lists what's relevant for Charlotte shoppers. Use it as a starting point, not the finish line.

Where to go for help

• Medicare.gov — the Medigap policy search tool by ZIP code.
• 1-800-MEDICARE — 24/7 for general Medicare questions.
• North Carolina SHIIP — free one-on-one counseling from trained volunteers.
• North Carolina Department of Insurance — the state Medigap rate guide.