Medigap Rates Explained


Click the photo to read the book.
Click the photo to read the book.

Recently, I was asked…

Can you share your experience with rate increases, if you’ve had this plan for more than a year?  And are XYZ‘s rate increases roughly in line with other carriers?

My wife joined the XYZ Plan F a year ago. Likes it.  I turn 65 in September.  We both have pre-existing conditions.  If I also sign up with AARP/UHC, I think there’s a modest ‘household’ discount.

I’m concerned about future rate increases, since it appears to me that we will not be able to change carriers without medical underwriting — unless we change to a Medicare Advantage plan (in which case, we may not be able to change back to a regular Medigap plan), or to a lower benefit plan within our carrier.

I thought the High Deductible Plan F might be a good choice in future if the regular Plan F rates get too high, but AARP/UHC says they’re “not currently offering the HD Plan F.  Should that worry me?

Below is the answer I sent to him.

Although Medigap is standard across the nation, the rates are not.  The amount, and timing of your rate increase will be determined by your State Department of Insurance.

Here in TX AARP Medigap plans tend to run on the high side.  That is not necessarily true for other states.

There is a huge difference between the regular Plan F and the HD Plan F.  Before you “pull the trigger” on the HD Plan F, take the time to look at your other options.  I work with Medigap clients and prefer Plan G.  It is typically much less than Plan F and only requires you to pay your Medicare B deductible each year.

Most importantly, if you truly do have a pre-existing condition, you will need to find a Medigap provider that you are willing to stick with for the rest of your life.  Your guaranteed issue right for Medigap is only the 7 months around your 65th birthday, unless you can qualify for a Special Election Period at a later date.  That is called your Initial Election Period.  After your Initial Election Period expires, you will be subject to medical underwriting if you ever decide to switch insurance companies in the future.

Remember, Medigap is not like Medicare Advantage.  There is no Annual Election Period when you can change insurance companies regardless of your health.

Tim Barnes, CLU has over 25 years experience working with insurance issues for middle-class Americans.  Read more about him on the ABOUT page of this blog.  If he is able to help you with your insurance questions, use the form on the left.

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