Choosing the right Medigap insurance company is one of the most important choices you will make when you turn 65. In most states, you only get one chance to choose a Medigap plan without the insurance provider checking your medical history. Senior65.com is here to help you get it right!
Why is it important to choose the right Medigap company?
When you first enroll in a Medigap plan, you have guaranteed issuance rights. This means that an insurance provider cannot turn you down based on your medical history.
Can I change my Medigap company later on?
It depends. In most states, insurance providers require that you go through medical underwriting before you can switch Medigap companies or plans. This means that a new insurance company can decline you based on your medical history.
A few examples of exceptions to this rule are the California Medigap Birthday Rule and Blue Shield of Ca’s Underwriting Holiday. Review Our Ultimate State-by-State Guide to the Medigap Birthday Rule. There are a few other states that allow for easy Medigap switching through guaranteed issued laws. Here is our complete list of ways to switch Medigap coverage by state.
Can I stay with the same Medigap company but change plans?
Again, this depends. In most states, your insurance provider will require you to go through medical underwriting to change from Medigap Plan A to G or vice versa. This means that you could be declined based on your past medical records.
Some exceptions to this are the Missouri Medigap Anniversary Rule and the Oregon Medigap Birthday Rule.
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How do I choose the right Medigap company?
Since Medigap plans are standardized, the core benefits of Medigap plans with the same letter (e.g. Plan G) are identical. This makes choosing an insurance company that offers Medigap rather simple in 3 easy steps:
- See which insurance company offers the Medigap plan you want at the best rate. You can use the Senior65.com instant Medigap quote tool here.
- Consider how the Medigap company increases its rate as you age. You will see this on the quote results. There are three types of Medigap pricing/rate scales used by companies: Medigap companies can offer age-attained, community-rated or issue-aged. Hint: Most insurance companies offer attained age pricing. Knowing what type will help determine how the company’s rates will increase over time.
- Forget your past insurance history. Go with the Medigap insurance company that offers the best price today and a good track record of keeping rates low.
This last point is very important. Many of our clients want to go with their current under65 insurance company but this can be a mistake. The insurance company that you had before you turned 65 will be nothing like the one that offers you Medigap. Since Medigap is standardized, all companies will offer the same exact core benefits and the same exact access to doctors. If your doctor accepts Medicare, she has to accept your new Medigap plan no matter what company it is from.
If you have had amazing (or poor) service in the past from an insurance provider, it will have little impact on your Medigap plan. Since Medigap is the secondary payer to Medicare, they have little room to offer great (or bad) customer service. The insurance company cannot deny coverage that Medicare approves so you are not on the phone trying to get authorization or payment for a procedure. They just do what Medicare tells them to do.
How do I choose the right Medigap plan?
Choosing a Medigap plan is often more important than choosing the right Medigap insurance company. Since you will not be able to easily switch between Medigap plans after you first enroll, it is important to get the right letter Medigap plan.
Choose the plan that you can afford the monthly premium and leaves you with affordable out-of-pocket costs. The chart below will help you clearly see the differences in plans:
| Benefits | A | B | D | G* | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,632) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($240) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100%** |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,060 | $3,530 |
*Plan G in California offers two additional options with additional benefits: Plan G Extra and Inspire.
**Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.
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Next Steps
For help understanding how Medigap insurance providers historically have increased rates, call one of our licensed agents at 800-930-7956. Our agents can NOT charge you a fee for a quote or to enroll you. So, give us a ring!