Medicare Supplement

How to compare the same Medigap plan letter across Winston-Salem insurers

Winston-Salem shoppers looking at Medigap often notice something confusing: two dozen or so insurers may sell the exact same plan letter in North Carolina, yet the way they price and manage those policies is not the same. Understanding what varies — and what doesn't — is the key to comparing them side by side.

Winston-Salem is in Forsyth County, but Medigap works differently from Medicare Advantage. Medigap policies are regulated at the state level, so any insurer approved to sell in North Carolina can sell to you in Winston-Salem. That means your shopping list is a statewide list, and the table below lists every insurer selling Medigap in North Carolina today.

The same letter is the same coverage

This is the single most important idea in Medigap shopping. Plan G at one insurer covers exactly the same gaps in Original Medicare as Plan G at any other insurer. Plan N is Plan N everywhere. The federal government standardized these letters, so insurers cannot add or remove benefits from a given letter.

That means when you compare insurers offering the same letter, you are not comparing benefits. You are comparing four things: how they price the policy, how their rates have moved over time, what discounts they offer, and how they handle underwriting if you apply outside your open enrollment window.

For people newly eligible for Medicare today, the available letters are A, B, D, G, G-HD, K, L, M and N. Plans C and F are only available to people who became eligible before January 1, 2020.

How insurers price the same plan letter

North Carolina insurers can use one of three pricing methods, and this is where identical coverage starts looking very different on paper.

Attained-age rated. The premium is based on your current age and generally rises as you get older. It often starts lower at 65 and climbs over time.

Issue-age rated. The premium is based on your age when you first buy the policy. It doesn't go up just because you had a birthday, though it can still rise due to inflation or overall rate increases.

Community-rated. Everyone who buys the same policy from that insurer pays the same base premium regardless of age.

None of these methods is automatically better — the right one depends on how long you plan to keep the policy and your budget today versus later. The North Carolina Department of Insurance publishes a Medigap rate guide that identifies which method each insurer uses.

Rate history matters as much as today's price

A low starting premium doesn't tell you much if the insurer raises rates aggressively year after year. Because Medigap policies renew annually, the trend matters. When you request quotes, ask each insurer (or your SHIP counselor) for the rate increase history over the last several years for the specific plan letter you're considering in North Carolina.

The state rate guide and Medicare.gov's Medigap policy search are the two official starting points. They won't hand you a prediction, but they help you see patterns.

Household discounts and other price levers

Several North Carolina insurers offer household discounts — a reduction if a spouse or another household member also has a policy with them, or sometimes just if another adult lives in your home. The size of the discount, and the rules for qualifying, vary by insurer. This alone can shift which insurer is the better match for a couple in Winston-Salem.

Some insurers also offer discounts for paying annually, using electronic funds transfer, or being a non-smoker. Ask about each one before you settle on a quote.

Underwriting: when and how insurers can say no

During your six-month Medigap Open Enrollment Period — which starts when you're 65 and enrolled in Part B — insurers in North Carolina must sell you any plan they offer, at their standard rate, regardless of your health.

Outside that window, most insurers can use medical underwriting. That means they can look at your health history and either charge more, offer a different plan, or decline coverage. Each insurer sets its own underwriting questions and standards. Two insurers may look at the same applicant and reach different decisions.

There are also limited "guaranteed issue" situations — for example, if your employer coverage ends or a Medicare Advantage plan leaves the area — where insurers cannot use underwriting. If you think one applies to you, verify it with 1-800-MEDICARE or your SHIP before applying.

How to actually compare insurers in Winston-Salem

Here's a practical order of operations:

1. Decide which plan letter fits your needs (Plan G, Plan N, a high-deductible option, etc.). 2. Pull the list of insurers selling that letter in North Carolina from the table below or from Medicare.gov's Medigap policy search using a Winston-Salem ZIP code. 3. For each insurer, note the pricing method, any household or payment discounts, and the rate-increase history. 4. Ask about underwriting rules if you're outside your open enrollment window. 5. Only after all of that, compare quotes — because a quote without context can mislead you.

Your local SHIP (the Seniors' Health Insurance Information Program in North Carolina) provides free, unbiased counseling and can walk through this comparison with you.