Medicare Supplement

Same Medigap letter, many insurers in Knoxville: how to compare them side by side

In Knoxville, a shopper who has decided on a Medigap plan letter — say Plan G or Plan N — quickly runs into a puzzle. Knoxville is in Knox County, and Tennessee lets dozens of insurance companies sell that exact same lettered plan. The coverage is identical from company to company, but the price, the way that price changes over time, and the rules for signing up are not. Understanding those differences is the real work of picking a Medigap policy.

This article walks through how to compare the same plan letter across the insurers licensed in Tennessee, without naming a premium. We are focused on the mechanics: pricing methods, rate history, household discounts, and medical underwriting.

The same letter is the same coverage

Medigap plans sold today are standardized. That means Plan G from one Tennessee insurer pays the same Medicare cost-sharing as Plan G from another. Plan N is Plan N. The federal government sets what each letter covers.

People who were eligible for Medicare before January 1, 2020 may still buy Plans C and F; everyone newly eligible today chooses from Plans A, B, D, G, G-HD, K, L, M, and N. The table below lists which letters each Tennessee insurer sells.

Because the benefits are fixed, comparing insurers is not about which one "gives you more." It is about price, price stability, service, and whether you can get in the door.

Who sells Medigap in Tennessee

A lot of companies do. Names you may recognize on the Tennessee list include AARP - UnitedHealthcare Insurance Company, AFLAC, Bankers Fidelity Assurance Company, BlueCross BlueShield of Tennessee, Cigna's HealthSpring Insurance Company, Continental Life Insurance Company of Brentwood, Tennessee (Aetna), Erie Family Life Insurance Company, Farm Bureau Health Plans, Humana, Medico Insurance Company, Mutual of Omaha (Omaha Supplemental Insurance Company), SilverScript Insurance Company, State Farm Mutual Automobile Insurance Company, and USAA Life Insurance Company, among many others. The full alphabetical list of insurers and the letters each one sells is in the table below.

Every one of those companies has to be licensed in Tennessee, and every one has to sell the standardized version of any letter it offers.

Three pricing methods — this matters more than most people realize

When you look at a Medigap quote, ask how the company sets the price. Tennessee allows three methods:

• Attained-age rated. The premium is based on your current age and generally goes up as you get older, in addition to any across-the-board rate increases. Prices often look lowest at age 65 and climb from there.
• Issue-age rated. The premium is based on the age you were when you first bought the policy. It still changes with inflation and claims, but it does not step up simply because you had another birthday.
• Community rated (also called no-age-rated). Everyone who buys that policy in Tennessee pays the same base premium, regardless of age.

None of these is automatically better. What matters is how the premium is likely to look at 75 or 85, not just at 65. Ask the agent or the company which method they use for the letter you are considering, and get it in writing.

Rate history: what has the company done in the past?

Two insurers can quote similar prices today and be on very different paths. A company that has raised rates 6% to 10% every year for a decade is telling you something about the future.

The Tennessee Department of Commerce and Insurance publishes Medigap rate information, and Medicare.gov's Medigap policy search shows how long a company has sold the plan and whether it has had recent increases. You can also ask the agent directly: "What have your Plan G rate increases looked like in Tennessee over the last three to five years?" A confident answer, backed by paper, is worth more than a low first-year quote.

Household discounts and other price levers

Many — not all — Tennessee Medigap insurers offer a household or "spousal" discount when two people at the same address both hold a policy with them, or sometimes when one adult in the household does. The size and rules vary by company. Some apply the discount even if only you enroll, if your spouse or roommate is Medicare-eligible.

Other levers to ask about:

• Discounts for paying annually or by electronic funds transfer.
• Whether the discount is a one-time credit or a permanent percentage.
• Whether the discount stays if your spouse later drops coverage.

Because the underlying coverage is identical, these small percentages are a legitimate part of comparing the same letter across companies.

Underwriting: when the company can say no

This is the part that surprises Knoxville shoppers most.

During your six-month Medigap Open Enrollment Period — which starts the month you are 65 or older and enrolled in Part B — any Tennessee insurer selling the letter you want must sell it to you, regardless of health history. You also have "guaranteed issue" rights in certain situations, such as losing group coverage.

Outside those windows, most insurers can (and do) ask health questions. They may decline you, charge more, or exclude conditions. The questions are not the same at every company. One insurer may reject an applicant for a condition another accepts. That is why people who want to switch Medigap plans later often shop several companies at once — a "no" from one is not a "no" from all.

If you are inside your Open Enrollment window, use it. It is the one time the door is guaranteed open.

A practical way to compare

A workable approach for a Knoxville resident:

1. Decide on the plan letter first (A, B, D, G, G-HD, K, L, M, or N). 2. Pull the list of Tennessee insurers that sell that letter from Medicare.gov's Medigap policy search or the state rate guide. 3. For each company, note the pricing method, rate history, household discount, and — if you are outside Open Enrollment — the underwriting questions. 4. Get quotes from at least three companies for the same letter, at your exact age and ZIP code. 5. Call the Tennessee SHIP (State Health Insurance Assistance Program) for a free, unbiased second look.