Medicare Supplement

Same Plan G, Different Insurer: What Changes in Texas

San Antonio, Texas — If you live in San Antonio and are shopping for a Medigap policy, here is something that surprises a lot of people: a Plan G is a Plan G, no matter which insurance company sells it. The federal government standardized these plans decades ago, so the coverage under a given letter is identical from one insurer to the next. What changes is the price, how that price is set, and the small rules each company uses to decide who can buy in and at what rate.

Medicare SupplementSan Antonio, TX

That is why comparing the same letter across several insurers is the heart of Medigap shopping in Texas.

Which Medigap letters you can buy today

If you are newly eligible for Medicare, the Medigap letters available to you in Texas are A, B, D, G, high-deductible G, K, L, M and N. Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.

The letter tells you what the policy covers. Once you pick a letter, your next job is to compare the insurers offering it in the San Antonio area.

The three ways Texas insurers price Medigap

Two policies with the same letter can cost very different amounts because insurers use different pricing methods. In Texas, you will see all three:

Attained-age rating. The premium is based on your current age and generally goes up as you get older. Attained-age policies often look inexpensive at 65 and grow more expensive over time.

Issue-age rating. The premium is based on the age you were when you bought the policy. It can still rise due to inflation and claims trends, but not simply because you had a birthday.

Community rating. Everyone in the same area pays the same premium regardless of age. These may start higher at 65 but tend to rise more slowly with age.

None of these methods is automatically better — the right fit depends on your age today, your budget and how long you expect to hold the policy.

Rate history matters as much as today's price

Because rates change over time, ask each insurer (or check the Texas Department of Insurance rate guide) for a rate history. A company with a track record of small, steady increases may serve you better than one with a low starting price and a history of large jumps.

The Texas Department of Insurance publishes a Medigap rate guide that lists insurers licensed in the state and often includes sample premiums by age. It is one of the most useful tools San Antonio shoppers overlook.

Household discounts and other pricing rules

Many — but not all — insurers offer a household discount when two people in the same home each hold a policy with the company, or when a spouse also has Medicare. Discount amounts and rules vary by company. Some require you to live together; some accept a second adult in the home; some apply the discount only after both policies are in force.

When you compare the same letter across insurers, ask specifically:

• Is there a household or spousal discount?
• Does it apply at enrollment or after a waiting period?
• What are the qualifying conditions?

A discount at one company can change the ranking of which policy is most affordable for your household.

Medical underwriting: timing changes everything

During your six-month Medigap Open Enrollment Period — which starts the month you are 65 or older and enrolled in Part B — insurers must sell you any Medigap policy they offer at the same price as a healthy person. No health questions, no denials.

Outside that window, Texas generally allows medical underwriting. That means insurers can ask about your health, charge more, or decline coverage. There are limited "guaranteed issue" situations (for example, if a group plan ends), but they are narrower than the initial open window.

This is why the Medigap Open Enrollment Period is often called a one-time shopping opportunity. If you are inside it, you have the broadest choice in San Antonio. If you are outside it, some insurers may still accept you — but the field narrows.

How to find every insurer selling in San Antonio

San Antonio is in Bexar County, and Medigap availability is set by insurer, not by the federal government's Medicare Advantage county map. To see every company offering Medigap in your ZIP code:

1. Go to Medicare.gov and use the Medigap policy search tool. Enter your ZIP code to pull up a list of insurers licensed to sell Medigap where you live. 2. Read the Texas Department of Insurance Medigap rate guide for pricing methods, rate histories and consumer complaint information. 3. Call the Texas SHIP (the Health Information, Counseling and Advocacy Program) for free, unbiased one-on-one counseling.

Once you have the list, pick the letter you want, and compare that same letter across insurers using the four levers in this article: pricing method, rate history, household discount and underwriting rules.