Medicare Supplement

Before You Buy Medigap in Philadelphia, Read This

In Philadelphia, shopping for a Medicare Supplement policy — better known as Medigap — comes with a quirk that surprises a lot of people. The letter on the plan (A, G, N and so on) means the same coverage no matter which company sells it. What changes from insurer to insurer is the price and the fine print around it. Here is how to compare Medigap options in Pennsylvania the right way, without getting distracted by brand names or ad copy.

Medicare SupplementPhiladelphia, PA

The same letter is the same coverage

Medigap plans are standardized. That means Plan G from Company A pays the same Part A and Part B cost-sharing that Plan G from Company B pays. The federal government sets the benefits inside each letter (A, B, D, G, G-HD, K, L, M and N are open to people newly eligible today; Plans C and F remain only for people eligible for Medicare before January 1, 2020).

So when you see an ad saying one company's Plan G is "better," that is marketing, not coverage. What actually differs between insurers is how much they charge, how they raise rates over time, whether they offer discounts, and how strict they are about accepting new applicants.

How to find the insurers selling in Philadelphia

Philadelphia is in Philadelphia County, and Medigap availability is set at the state and ZIP-code level in Pennsylvania. Because we do not publish a carrier list here, use these official sources to see who is currently selling:

• Medicare.gov Medigap policy search. Enter your ZIP code at medicare.gov to see every insurer licensed to sell Medigap policies in your area, along with each plan letter they offer.
• Pennsylvania Insurance Department rate guide. The department publishes a Medigap rate comparison guide for consumers, which lists insurers and how their premiums compare.
• APPRISE, Pennsylvania's SHIP. The State Health Insurance Assistance Program offers free, unbiased counseling by phone and in person, including help sorting through Medigap options.

The table on this page lists the plan letters available. Once you have the list of insurers from Medicare.gov, you can line them up letter by letter.

Pricing methods: attained-age, issue-age and community rating

This is where two policies with the exact same benefits can look very different over time. Insurers in Pennsylvania generally use one of three pricing methods:

• Attained-age rated. The premium is based on your current age and typically goes up as you get older, in addition to any general rate increases.
• Issue-age rated. The premium is based on your age when you first bought the policy. It does not go up just because you age, though it can still rise for other reasons like inflation.
• Community rated. Everyone in the same area pays the same premium regardless of age. Rates can still change, but not because you had a birthday.

A policy that looks affordable at 65 under attained-age pricing may cost noticeably more at 75. When you compare two insurers offering the same letter, ask which method they use.

Rate history, household discounts and underwriting

Three more things separate one insurer's Plan G (or N, or any other letter) from another's:

• Rate history. Past rate increases are not a promise about the future, but they are a data point. The Pennsylvania Insurance Department's rate guide can show how insurers have adjusted premiums over time.
• Household discounts. Some insurers reduce the premium when more than one adult in the household has a policy with them, or when a spouse or partner lives at the same address. The rules vary a lot by company.
• Medical underwriting. During your six-month Medigap open enrollment period — which starts when you are 65 or older and enrolled in Part B — insurers must sell you any Medigap policy they offer, regardless of health. Outside that window, and outside of specific guaranteed-issue situations, Pennsylvania insurers can generally ask health questions and decline or price up an application. This is why timing matters.

How to compare, step by step

1. Pick the plan letter that fits your budget and how you use care. This choice is about coverage, not brand. 2. Use the Medicare.gov Medigap policy search to see every insurer offering that letter in your ZIP code. 3. For each insurer, ask (or check the rate guide for): the pricing method, recent rate changes, any household or other discounts, and whether they will underwrite your application. 4. Compare quotes for the same plan letter, apples to apples. 5. If anything is unclear, call APPRISE or 1-800-MEDICARE before you sign.