Medicare Supplement

Medigap in Fort Worth: how to compare the same plan letter across Texas insurers

If you live in Fort Worth and you are shopping for a Medicare Supplement policy, the first thing to know is this: a Plan G is a Plan G, no matter which company sells it. The federal government standardizes Medigap coverage by letter, so the benefits inside each lettered plan are the same at every insurer licensed in Texas. What actually changes from one company to the next is the price, how that price is set, how often it goes up, and whether you can get in without answering health questions.

Medicare SupplementFort Worth, TX

That is where the real comparison shopping happens. Here is how to do it in Tarrant County.

Fort Worth is in Tarrant County — but Medigap is regulated statewide

Medicare Advantage and Part D plans are sold county by county, but Medigap works differently. Any insurer licensed to sell Medicare Supplement in Texas can sell to a Fort Worth resident, and the plan letters available here are the same ones available across the state.

For people who become eligible for Medicare today, the standardized letters are A, B, D, G, high-deductible G, K, L, M and N. Plans C and F are still around, but only for people who were eligible for Medicare before January 1, 2020.

How to find every insurer selling Medigap in Texas

There is no single short list of Medigap carriers we can print here, because insurers move in and out of the market and the roster changes. The good news is that finding the current list is straightforward:

• Medicare.gov Medigap policy search. Enter your Fort Worth ZIP code at medicare.gov and choose the plan letter you want to compare. You will get a list of every insurer offering that letter, with contact information.
• Texas Department of Insurance rate guide. TDI publishes a Medicare Supplement rate guide that shows insurers licensed in Texas and sample premiums by age.
• Texas SHIP (HICAP). The State Health Insurance Assistance Program offers free, one-on-one counseling and can walk you through the list without trying to sell you anything.

Once you have the list, the comparison is about four things: pricing method, rate history, discounts and underwriting.

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

This is the single biggest thing most shoppers miss. Two insurers can sell the exact same Plan G and use very different math to set your premium.

• Attained-age rated. The premium is based on your current age and generally goes up as you get older. It often starts lower at 65 and rises over time.
• Issue-age rated. The premium is based on the age you were when you first bought the policy. It does not go up just because you had a birthday, though it can still change for other reasons.
• Community-rated. Everyone in the same area pays the same premium, regardless of age.

None of these is automatically better — it depends on how long you plan to keep the plan and how you want your budget to look at 75 or 80. Ask each insurer, in writing, which method it uses.

Rate-change history: what the past few years looked like

Every Medigap premium can change over time because of inflation, medical costs and the insurer's own claims experience. What you want to know is how often a given insurer has raised rates on the plan letter you are considering, and by roughly how much.

The Texas Department of Insurance rate guide is the cleanest place to look at this pattern. Your SHIP counselor can also help you read it. An insurer with a long, steady rate history on Plan G tells you something different from one that has raised rates sharply two years in a row.

Household discounts and other price levers

Many — not all — Texas Medigap insurers offer a household discount when more than one adult in the same home has a policy with them. The size of the discount, and the rules for qualifying (spouse only, any adult living together, must both enroll at the same time), vary a lot.

When you call each insurer or work with an agent, ask specifically:

• Do you offer a household or spousal discount on this plan letter?
• What are the eligibility rules?
• Are there other discounts, such as for paying annually or by bank draft?

Underwriting: can you get in without health questions?

This is where timing matters more than any single company you pick.

During your six-month Medigap Open Enrollment Period — which starts the month you are 65 or older AND enrolled in Part B — insurers in Texas must sell you any Medigap plan they offer, at their best available rate for your age, without asking about your health. This is a federal right.

Outside that window, most Texas insurers can use medical underwriting. That means they can ask health questions and either decline you or charge more. A few situations, called guaranteed-issue rights, let you buy certain plans without underwriting even later — for example, if your employer coverage ends or a Medicare Advantage plan you joined at 65 does not work out within the first year.

Before you switch from one Medigap insurer to another after your open enrollment window closes, ask the new company whether you will have to go through underwriting. The answer can change everything.

Putting it together

The table below lists the plan letters available to new enrollees. When you compare insurers for the letter you want:

1. Pull the list from Medicare.gov and the TDI rate guide. 2. For each insurer, note the pricing method, recent rate history, any household discount, and whether underwriting applies to you right now. 3. Then, and only then, look at price.

Because the coverage inside a lettered plan is identical, the "best" insurer for one Fort Worth resident is not necessarily the best for another. It comes down to your age, your household, your health and how long you plan to keep the policy.