5 Best Medigap Insurance Companies Compared

Table of Contents

One of the most confusing things about Medigap is that the plans are standardized. This means a Plan G from one company offers the exact same basic benefits as a Plan G from any other company. So, if the coverage is identical, what are you actually choosing? You’re choosing the company itself. You’re comparing their monthly premiums, their history of rate increases, their financial strength, and their reputation for customer service. Finding the right fit is about more than just the plan letter; it’s about finding a reliable partner for your healthcare journey. We’ll show you how to evaluate the best medigap insurance companies so you can make a choice with confidence.

Key Takeaways

Compare the companies, not just the coverage: Medigap plan benefits are standardized, so a Plan G is a Plan G no matter who sells it. Focus your decision on factors that differ between insurers, like their premium, rate increase history, and customer service reputation.
Prioritize your Open Enrollment Period: You have a crucial six-month window when you turn 65 and enroll in Part B to buy any Medigap plan, regardless of your health. Missing this one-time opportunity can result in higher premiums or being denied coverage.
Look beyond the initial price tag for long-term value: The cheapest plan today might not be the best deal tomorrow. Investigate a company’s history of rate increases and ask about available household discounts to find a policy that will remain affordable over time.

What Is Medigap and How Does It Work?

When you enroll in Original Medicare (Parts A and B), you’ll quickly notice that while it covers a lot of your healthcare services, it doesn’t cover everything. You’re still responsible for certain out-of-pocket expenses, and these “gaps” in coverage can add up. This is where Medigap comes in to help.

Medigap is a type of private insurance, also known as a Medicare Supplement plan, that you can buy to help pay for the costs that Original Medicare doesn’t cover. Think of it as a safety net that picks up the bills for things like your deductibles, copayments, and coinsurance. For example, after you’ve paid your Part B deductible for the year, Medicare typically covers 80% of your outpatient medical costs. A Medigap plan can step in to cover the remaining 20%, which can be a huge relief if you need frequent medical care.

These plans are sold by private insurance companies but are regulated by the federal government. This means that while the companies and their prices differ, the basic benefits of each plan are standardized. This makes it much easier to compare your options and find a plan that fits your needs and budget.

What Are Medicare Supplement Plans?

You’ll often hear the terms “Medigap” and “Medicare Supplement” used interchangeably, and that’s because they are the exact same thing. These plans are designed to work alongside your Original Medicare benefits, not replace them. To be eligible for a Medigap plan, you must be enrolled in both Medicare Part A and Part B.

Once you have a Medigap plan, it works automatically with Medicare. When you visit a doctor or hospital that accepts Medicare, you’ll show both your Medicare card and your Medigap card. Medicare will pay its share of the approved amount for your care first, and then your Medigap plan will pay its share. This seamless process helps cover your out-of-pocket costs and gives you more predictable healthcare expenses.

How Medigap Fills Medicare’s Gaps

One of the best things about Medigap is that the plans are standardized. This means that a Plan G from one insurance company must offer the exact same basic benefits as a Plan G from any other company. The same is true for all the other lettered plans, like Plan F or Plan N. This standardization takes the guesswork out of comparing coverage.

Because the benefits are the same for each plan letter, you can focus on the factors that really set companies apart: price, customer service, and financial stability. You don’t have to worry that one company’s Plan G is secretly less comprehensive than another’s. Your job is to find the company that offers the plan you want at the best price with a reputation for taking care of its members.

Clearing Up Common Medigap Myths

The most common point of confusion is the difference between Medigap and Medicare Advantage. Let’s clear this up: they are two completely different types of coverage. Medigap plans work with Original Medicare to cover out-of-pocket costs. In contrast, Medicare Advantage Plans are an alternative to Original Medicare, bundling your Part A, Part B, and often Part D (prescription drug) benefits into one plan offered by a private insurer. You cannot have both a Medigap plan and a Medicare Advantage Plan at the same time.

Another myth is that all Medigap plans cost the same since their benefits are standardized. This isn’t true. Each insurance company sets its own monthly premiums, and prices can vary significantly based on the company, your location, age, and other factors.

Who Are the Best Medigap Insurance Companies?

One of the most common questions we hear is, “Which company should I choose?” It’s a great question because while Medigap plan benefits are standardized by the government (meaning a Plan G from one company has the same basic benefits as a Plan G from another), the companies themselves are very different. They set their own monthly premiums, have different histories of rate increases, and vary widely in customer service and financial stability.

Choosing the right company is just as important as choosing the right plan. The “best” company for you will depend on your budget, where you live, and what you value most in an insurance provider. Some companies are known for rock-solid customer service, while others compete on price or offer unique discounts. To help you get started, we’ve put together a list of companies that consistently stand out in the industry. Think of this as a starting point for your research as you find a Medigap policy that fits your needs.

Our Top Recommended Companies

When we look at Medigap carriers, we focus on a few key things: financial strength, customer satisfaction, competitive pricing, and a stable history of rate increases. The companies below have built strong reputations by delivering on these fronts. They are major players in the Medigap market and are known for providing reliable coverage and service to their members. Let’s walk through what makes each of them a solid choice to consider.

AARP/UnitedHealthcare: A Leader in Coverage

You’ve likely seen the AARP name before, and for good reason. AARP/UnitedHealthcare is one of the largest and most recognized providers of Medigap plans in the country. They are available in all 50 states, which is a huge plus for those who might move in retirement. Their plans consistently receive high marks for overall choice and customer satisfaction, with very few member complaints. This combination of wide availability and a strong service reputation makes them a dependable option for almost anyone seeking Medigap coverage.

Mutual of Omaha: A Focus on Value

Mutual of Omaha has been a trusted name in insurance for over a century, and they have a strong presence in the Medigap market. They are particularly well-regarded for offering excellent value. One of their most popular features is a household premium discount, which can be up to 12% in some states if you live with a spouse or another adult. This can lead to significant savings over time. With a history of very few customer complaints, Mutual of Omaha is a great choice for those who want quality coverage without overpaying.

Anthem Blue Cross Blue Shield: Options for Extra Benefits

Anthem is a great company to look at if you’re interested in bundling extra benefits with your Medigap plan. While most Medigap policies don’t include routine dental or vision coverage, Anthem often allows you to add these benefits to your plan for an additional premium. This can be a convenient way to manage your health coverage under one roof. Anthem is also known for offering competitive pricing, particularly for the popular Plan G, making it a strong contender in many states.

State Farm: A Top Choice for Member Satisfaction

While you might know them for home and auto insurance, State Farm also offers Medigap plans in many states. Their biggest strength is member satisfaction. Policyholders rarely file complaints, which speaks volumes about the quality of their service and how they handle claims. If having a smooth, hassle-free experience with your insurance company is a top priority, State Farm is definitely worth a look. Their pricing can also be quite competitive, especially in areas with a higher cost of living.

Wellabe: An Affordable Option

If your primary focus is finding a low monthly premium, Wellabe should be on your list. Formerly known as Medico, Wellabe often offers some of the most affordable rates for popular plans like Plan G and Plan N. This can make a real difference in your monthly budget, especially if you’re on a fixed income. While they may not have the same household name recognition as some other carriers, their commitment to competitive pricing makes them an attractive option for budget-conscious shoppers looking for reliable Medigap coverage.

How to Compare Medigap Companies

One of the most important things to understand about Medigap is that the plans are standardized. That means a Plan G from one company has the exact same core benefits as a Plan G from another company. So, if the plans are the same, what are you actually comparing? You’re comparing the companies themselves.

Choosing the right company is just as important as choosing the right plan. You’re looking for a partner in your health care journey—one that is reliable, fair, and easy to work with. While one company might offer the lowest premium today, another might provide better long-term value through stable rates and excellent customer service. To make a confident decision, you’ll want to look beyond the initial price tag and evaluate each insurer on a few key factors: their financial health, customer satisfaction record, pricing history, and any extra discounts they might offer. Taking the time to weigh these elements will help you find a company you can count on for years to come.

Check Their Financial Stability

Before you sign up with any insurance company, you want to be sure it has the financial strength to pay your claims, now and in the future. Think of it as checking the foundation of a house before you buy it. A great way to do this is by looking at their ratings from independent agencies like A.M. Best. These agencies analyze an insurer’s financial health and assign it a grade. Most of the top Medigap companies hold an ‘A’ (Excellent) or ‘A+’ (Superior) rating. A strong rating gives you peace of mind, knowing your provider is on solid ground and can meet its financial obligations to you when you need it most.

Review Customer Satisfaction and Complaint History

A company’s financial rating tells you if they can pay claims, but its customer service record tells you how they treat people. How does the company handle problems? Are members generally happy with the service they receive? You can get a good sense of this by looking at their complaint history. The National Association of Insurance Commissioners (NAIC) maintains a database where you can check for complaints filed against insurers. For example, a company like State Farm consistently has complaint rates well below the industry average, which is a strong indicator of high member satisfaction. A little research here can save you a lot of frustration later.

Confirm They Offer Plans Where You Live

This might seem obvious, but it’s a crucial first step that can save you a lot of time. Insurance is regulated at the state level, and not every company offers Medigap plans in every state or even every ZIP code. A company might be a great option for your friend in another state, but it won’t do you any good if it doesn’t serve your area. Before you get too far into comparing rates and benefits, confirm which companies and plans are available where you live. You can typically do this right on the company’s website or by using Medicare’s official plan finding tool.

Understand Their Pricing and Rate Increase History

The premium you’re quoted today is just the starting point. Medigap premiums will increase over time, so it’s important to understand how a company has handled rate increases in the past. Some companies might lure you in with a very low introductory rate, only to implement steep increases later on. Instead, look for a company with a history of steady, predictable rate adjustments. This is where an experienced agent can be incredibly helpful, as they often have access to historical rate data. Choosing a company with a stable pricing history can lead to more affordable coverage in the long run.

Look for Extra Perks and Discounts

While the core benefits of a Medigap plan are standardized, some companies offer additional perks or discounts that can add value. The most common is a household discount, which can lower your premium if you and a spouse or partner living in the same home are both enrolled with the same company. These discounts typically range from 5% to 12% and can result in significant savings over the year. When you’re getting quotes, always ask if you qualify for a household discount or any other available perks. It’s an easy way to reduce your monthly costs without sacrificing any coverage.

A Quick Comparison of Popular Medigap Plans

While all Medigap plans are standardized, a few consistently stand out as popular choices. Think of these as the greatest hits album of Medigap. Understanding the key differences between Plans F, G, and N can help you narrow down your options and find a policy that fits your health needs and budget. Each one offers a different balance of monthly premiums and out-of-pocket costs, so let’s look at what makes each one unique.

Plan G: The Go-To for New Enrollees

If you became eligible for Medicare on or after January 1, 2020, Medigap Plan G is likely the most comprehensive coverage you can buy. It has quickly become one of the most popular choices for new enrollees, and for good reason. Plan G covers nearly all the gaps in Original Medicare, including coinsurance and hospital deductibles.

The only significant cost it doesn’t cover is the annual Medicare Part B deductible. Once you pay that deductible out-of-pocket each year, Plan G picks up the rest of your Medicare-approved costs. This makes your healthcare expenses highly predictable, which offers incredible peace of mind.

Plan F: The Most Comprehensive (If You’re Eligible)

For years, Plan F was the gold standard of Medigap coverage because it covers everything Original Medicare doesn’t, including the Part B deductible. However, a change in federal law means Plan F is no longer available to new Medicare beneficiaries.

You can only purchase Plan F if you were eligible for Medicare before January 1, 2020. If you fall into that group, you may still be able to enroll in this plan. Because it offers first-dollar coverage, its premiums are typically the highest. For those who qualify and want the absolute maximum coverage with virtually no out-of-pocket costs for Medicare-approved services, Plan F remains an attractive, though exclusive, option.

Plan N: A Balance of Lower Premiums and Predictable Costs

Think of Plan N as a great middle-of-the-road option. It offers robust coverage but comes with a lower monthly premium compared to Plan G. In exchange for that lower premium, you agree to handle some small, predictable out-of-pocket costs.

Like Plan G, you’ll still be responsible for the annual Part B deductible. After that, you may have a copayment of up to $20 for some doctor’s office visits and up to $50 for an emergency room visit that doesn’t result in a hospital admission. If you’re generally healthy and don’t mind small, occasional copays, Plan N can be a smart way to save money on your monthly premium without sacrificing significant coverage.

High-Deductible Plans: Lower Premiums, Higher Out-of-Pocket

For those who want to keep their monthly premiums as low as possible, a high-deductible version of Plan G or Plan F (if eligible) might be the right fit. With these plans, you pay a significantly lower monthly premium. The trade-off is that you must first pay a larger annual deductible out of your own pocket before the Medigap plan begins to cover your costs.

This deductible is separate from the Part B deductible. A high-deductible plan can be a good choice if you’re in excellent health and have enough savings to cover the deductible if a major health issue arises. It provides a safety net against catastrophic costs while keeping your fixed monthly expenses to a minimum.

When Should You Enroll in a Medigap Plan?

When it comes to Medigap, timing is everything. Choosing the right time to apply for a plan is just as important as picking the right company or coverage level. Certain enrollment periods give you special protections, making it much easier to get the plan you want without any hassle. If you miss these windows, you could face higher costs or even be denied coverage altogether. Let’s walk through the key timelines you need to know so you can make your move at the best possible moment.

Why Your Open Enrollment Period Is the Best Time to Apply

Think of your Medigap Open Enrollment Period as your golden ticket. It’s a one-time, six-month window that begins on the first day of the month you’re both 65 or older and enrolled in Medicare Part B. During this period, you have the absolute right to buy any Medigap plan sold in your state. According to the National Council on Aging, insurance companies cannot use medical underwriting to decide whether to accept your application. This means they can’t refuse to sell you a policy or charge you a higher premium because of your health history. This is your one and only chance to get any plan you want, guaranteed.

What Are Guaranteed Issue Rights?

If you’ve already missed your Open Enrollment Period, don’t panic—you might have another opportunity. Certain situations give you “guaranteed issue rights,” which work similarly to open enrollment. These rights mean you can buy a Medigap policy without going through medical underwriting. These situations are usually triggered when you lose other types of health coverage, such as an employer plan or a Medicare Advantage Plan. The Kaiser Family Foundation notes that you typically have 63 days from when your other coverage ends to apply for a Medigap plan under these rights. It’s a critical safety net that ensures you can still get coverage when life changes.

Applying Outside of Open Enrollment

What happens if you apply for a Medigap plan without the protection of your Open Enrollment Period or a guaranteed issue right? In that case, insurance companies can use medical underwriting. This is a process where the insurer reviews your medical history to assess their risk in covering you. As California Health Advocates explains, this could lead to a few outcomes: the company might charge you a higher premium, refuse to cover your pre-existing conditions for a waiting period, or deny your application entirely. This is why we always stress the importance of enrolling as soon as you’re eligible—it’s the simplest and most secure way to get the coverage you need.

How Much Does Medigap Cost?

This is the big question, isn’t it? You want to know what this is going to cost, and the truth is, there’s no single price tag. While Medigap plan benefits are standardized by the government—meaning a Plan G from one company has the exact same basic benefits as a Plan G from another—the prices are not. Insurance companies are free to set their own monthly premiums, and the difference can be hundreds of dollars a year for the same exact coverage. This is why shopping around is so important.

Understanding how companies price their plans and what factors influence your personal premium is the key to finding a plan that fits your budget now and in the future. It’s not just about finding the cheapest plan today; it’s about finding the best value from a stable company that will be there for you down the road. A low introductory rate might look great, but if that company has a history of sharp price increases, you could end up paying much more over time. Let’s break down what goes into the cost of a Medigap plan so you can feel confident when you start comparing your options.

How Companies Price Their Premiums

Insurance companies use one of three methods to set their Medigap premiums, and the method they use can have a big impact on what you pay over time. The most common approach is attained-age-rated, where your premium starts low but increases as you get older. Another is issue-age-rated, which bases your premium on your age when you first buy the policy; it won’t go up just because you have a birthday. The third, less common method is community-rated, where everyone in a specific area pays the same premium, regardless of their age. Understanding which pricing method a company uses is crucial for predicting future costs.

What Affects Your Monthly Premium?

Several personal factors will influence the specific premium you’re quoted for a Medigap plan. Your location is a major one—premiums can vary significantly by state and even by zip code. Your age, gender, and whether you use tobacco can also affect your rate. The most important factor, however, is when you apply. Buying a plan during your Medigap Open Enrollment Period gives you the best prices because companies can’t use your health history to charge you more. A company’s history of rate increases is another critical piece of the puzzle. A low starting premium might seem appealing, but it could be followed by steep hikes later on.

How to Compare Costs from Different Companies

When you start getting quotes, make sure you’re making an apples-to-apples comparison. This means looking at the same plan letter (for example, Plan G) from several different companies. Since the benefits are identical, you can focus on price and company stability. Don’t just look at the initial monthly premium. Ask about the company’s rate increase history over the past few years to get a sense of how stable their pricing is. Also, be sure to ask about any available discounts. Many companies offer a household discount if you and your spouse both enroll in a plan with them, which can save you money every month.

Common Mistakes to Avoid When Choosing a Medigap Plan

Choosing a Medigap plan is a big decision, and it’s easy to get tripped up by a few common hurdles. Knowing what to watch out for can make the process much smoother and help you land on a plan that truly fits your needs. By avoiding these frequent missteps, you can feel more confident that you’re making a smart choice for your health and your wallet. Let’s walk through three of the biggest mistakes we see people make and how you can sidestep them.

Mistake #1: Missing Your Enrollment Window

One of the most critical mistakes you can make is missing your Medigap Open Enrollment Period. This is your golden ticket—a one-time, six-month window that starts the month you turn 65 and enroll in Medicare Part B. During this period, insurance companies can’t use your health history to deny you coverage or charge you more. If you miss this window, you could face limited options, higher premiums, or even be denied a policy altogether. Think of it as a one-time opportunity to get any Medigap plan you want, so be sure to mark it on your calendar.

Mistake #2: Choosing a Plan Based Only on Price

While your budget is definitely an important factor, picking a Medigap plan just because it has the lowest premium can be a risky move. A price that seems too good to be true might be a red flag for a company with a history of steep rate increases or less-than-stellar customer service. Instead of focusing only on the monthly cost, look at the bigger picture. Consider the company’s financial stability and its reputation for paying claims fairly and promptly. The goal is to find a plan that offers solid value and peace of mind, not just the cheapest price tag today.

Mistake #3: Confusing Medigap with Medicare Advantage

It’s very common for people to mix up Medigap and Medicare Advantage, but they work in completely different ways. It’s essential to understand the distinction. Medigap plans are designed to supplement Original Medicare, helping to pay for out-of-pocket costs like deductibles and coinsurance. Medicare Advantage plans, on the other hand, are an alternative to Original Medicare. They bundle your hospital, medical, and often prescription drug coverage into one plan, usually with a specific network of doctors. You can’t have both, so knowing the difference between Medigap and Medicare Advantage is the first step to choosing the right path for you.

Your Checklist for Comparing Medigap Companies

Once you have quotes from a few financially stable companies, it’s time to dig a little deeper. Since Medigap plan benefits are standardized by the government, you’re not just choosing a plan—you’re choosing a company to partner with for your health care. The price is important, but so are customer service and long-term rate stability.

Think of it like this: a Plan G is a Plan G, no matter who sells it. The real difference lies in the company’s reputation, how they treat their members, and how predictable their premiums will be over time. A low price today isn’t a great deal if it comes with poor service or a massive rate hike next year. This checklist will help you look beyond the initial premium to find a company you can rely on for years to come.

Research Their Complaint History

Before you commit to a company, do a little homework on their customer service track record. You can see if policyholders have filed complaints against an insurer by checking with your state’s department of insurance. The National Association of Insurance Commissioners (NAIC) has a map with links to each state’s department, making it easy to find the right place. You can also check a company’s rating with the Better Business Bureau (BBB). A pattern of complaints about claim denials or slow processing can be a major red flag, signaling potential headaches for you down the road.

Check Their History of Rate Increases

A low introductory premium can be tempting, but it’s crucial to look at the bigger picture. You’ll want to find a company known for steady, predictable rate increases, not one that lures you in with a low price only to implement steep hikes later. Some companies price their plans aggressively to attract new, younger members, but this can lead to larger increases in the future. An experienced independent agent can provide data on a company’s rate increase history, giving you a clearer idea of what to expect and helping you avoid unpleasant surprises.

Ask About Household and Other Discounts

Don’t forget to ask about potential savings. Many Medigap insurance companies offer a household discount, which can reduce your monthly premium if you and your spouse or partner are both enrolled in a plan with the same company. These discounts typically range from 5% to 12% and can add up to significant savings over the year. The rules for eligibility can vary—some require you to apply at the same time, while others just require you to live in the same home. It never hurts to ask your agent what discounts might be available to you.

Remember That Plan Benefits Are Standardized

This is a point worth repeating: Medigap plans are standardized. This means that the basic benefits for each lettered plan are the same, regardless of which insurance company sells it. A Plan G from one company covers the exact same Medicare-approved services as a Plan G from another. This is great news for you because it simplifies the comparison process. You don’t have to worry that you’re missing out on key benefits by choosing a lower-cost company. Instead, you can focus on the factors that truly differ: premium, rate stability, and customer service. You can compare Medigap policies on the official Medicare website.

How to Find the Right Medigap Plan for You

Choosing a Medigap plan feels like a huge decision because it is. This is the policy that will work alongside your Original Medicare for years to come, so you want to get it right. The key is to find a plan that fits your life—not just your budget, but your health needs and your peace of mind, too. It’s a balancing act. You’re looking for that sweet spot where you have enough coverage to sleep soundly at night without paying for benefits you’ll likely never use.

Think of it less like a test with one right answer and more like tailoring a suit. The best fit for your neighbor might not be the best fit for you. By taking a clear look at your personal situation, you can confidently select a plan that protects both your health and your savings. We’ll walk through the three main areas to consider: your budget, your health, and your long-term financial security.

Balance the Coverage You Need with the Premium You Can Afford

While Medigap plans are standardized by the government—meaning a Plan G from one company has the exact same medical benefits as a Plan G from another—the prices can be wildly different. This is why it’s so important to compare costs from several insurers.

When you’re looking at premiums, think about what you can comfortably afford each month. But don’t stop there. The cheapest plan today isn’t always the best long-term value. You’ll also want to consider the insurance company’s history of rate increases, its customer service reputation, and its financial stability. A slightly higher premium might be worth it for a company that is reliable and has a track record of smaller, more predictable rate adjustments over time.

Think About Your Current and Future Health Needs

Take a moment for an honest assessment of your health. Do you have chronic conditions that require frequent doctor visits? Do you anticipate needing more medical care in the coming years? If so, a more comprehensive plan like Plan G might be the right choice, as it covers nearly all of your out-of-pocket costs.

On the other hand, if you’re in excellent health and rarely see a doctor outside of annual checkups, you might prefer a plan with a lower premium, like Plan N. The best plan for you truly depends on this personal calculation. It’s about matching the level of coverage to your specific health profile and how much financial risk you’re comfortable taking on.

Plan for Potential Medical Expenses Down the Road

One of the biggest risks with Original Medicare is that it has no annual out-of-pocket maximum. A serious illness or unexpected accident could leave you with overwhelming medical bills. This is where a Medigap plan becomes your financial safety net, protecting your retirement savings from the unknown.

This is also why timing is so important. Your one-time Medigap open enrollment period is your golden ticket. It’s a six-month window that starts when you’re 65 or older and enrolled in Medicare Part B. During this time, insurance companies cannot use your health history to deny you a policy or charge you more. Missing this window can make it much harder and more expensive to get coverage later, so planning ahead is crucial.

Ready to Apply? Here’s How It Works

Once you’ve compared companies and have a Medigap plan in mind, the next step is the application. The process can be straightforward, especially if you apply at the right time. It’s all about knowing when to act and what information to have on hand. Let’s walk through what the application process looks like and how you can make it as smooth as possible.

The Application Process and What You’ll Need

The best time to apply for a Medigap plan is during your one-time Medigap Open Enrollment Period. This six-month window starts on the first day of the month you’re 65 or older and enrolled in Medicare Part B. During this period, insurance companies can’t use your health history to deny you coverage or charge you more. To apply, you’ll typically need your Medicare card, which has your Medicare number and your Part A and Part B start dates. You can apply directly with the insurance company or with the help of a licensed agent. It’s a good idea to apply a month or two before you want your policy to start to ensure there are no gaps in your coverage.

How a Licensed Agent Can Help

You don’t have to go through the application process alone. Working with an independent licensed agent can make things much easier and won’t cost you anything extra. An agent acts as your advocate, helping you compare plans from multiple insurance companies to find the one that truly fits your needs and budget. They can check for household discounts, explain the fine print, and handle all the application paperwork for you. Think of it as having a personal guide to help you through the Medicare maze. They can answer your questions and give you the confidence that you’re making a well-informed decision without the pressure of doing it all yourself.

What to Expect if You Need Medical Underwriting

If you apply for a Medigap plan outside of your Open Enrollment Period, the process looks a bit different. Unless you have a guaranteed issue right—a special circumstance, like losing other health coverage—the insurance company can require medical underwriting. This means you’ll have to answer a series of health questions on your application. The company will review your medical history to decide whether to approve your application and what premium to charge. A pre-existing condition could result in a higher premium or even a denial of coverage, which is why timing your application is so important.

Frequently Asked Questions

If all Plan Gs have the same benefits, why shouldn’t I just pick the cheapest one? That’s a great question because it seems like the most logical thing to do. While the benefits of a Plan G are identical from company to company, the companies themselves are very different. The initial low price you see today is only one piece of the puzzle. You also want to consider the company’s history of rate increases and its customer service reputation. A plan that’s cheap now could have steep price hikes later, costing you more in the long run. The goal is to find a company that offers a fair price now and has a track record of stable, predictable rates for the future.

I’m over 65 and missed my initial enrollment window. Is it too late to get a Medigap plan? Not necessarily, so don’t worry. While your six-month Medigap Open Enrollment Period is the absolute best time to apply because you’re guaranteed acceptance, you can still apply for a plan at any time. The main difference is that the insurance company can now use medical underwriting. This means you’ll have to answer health questions, and the company can decide to charge you a higher premium or even deny your application based on your health history.

Will my Medigap premium increase as I get older? You should expect your premium to go up over time. Most Medigap plans are priced so that the rate increases as you age. These increases also happen to cover the rising cost of healthcare in general. The key is to find a company with a history of moderate and predictable rate adjustments rather than one known for sudden, steep hikes. An experienced agent can often provide insight into a company’s rate history to help you make a more informed choice.

Can you explain the difference between Medigap and Medicare Advantage one more time? Of course, as this is the most common point of confusion. Think of it this way: a Medigap plan works with your Original Medicare as a partner. You keep Medicare as your primary coverage, and the Medigap plan helps pay for the out-of-pocket costs that Medicare doesn’t cover. A Medicare Advantage plan is an alternative to Original Medicare. You get your health benefits from a private insurance company instead of from the federal government, often with different rules, costs, and doctor networks. You cannot have both at the same time.

Does a Medigap plan mean I can see any doctor I want? Yes, one of the best features of having a Medigap plan is the freedom it gives you. As long as your doctor or hospital accepts Original Medicare, you can receive care there, and your Medigap plan will work seamlessly with it. You are not restricted to a specific network of providers, which gives you the flexibility to see specialists and get care anywhere in the U.S. that accepts Medicare.