What it is
A premium and rate review is a close look at your current Medigap policy and what it costs. It is meant for people who already have coverage and want to understand a price change or see whether a different choice might suit them.
Most reviews cover three things. First, why your premium went up, such as a change tied to your age, the way your carrier prices its plans, or general cost trends. Second, how other companies selling the same standardized plan letter compare. Third, whether you qualify for any household or other discounts.
Medigap plans with the same letter offer the same basic benefits in most states, no matter which company sells them. That is why the price and the carrier's service are often the main differences. Massachusetts, Minnesota and Wisconsin standardize Medigap differently, so check how your state works. Plans C and F are open only to people who became eligible for Medicare before January 1, 2020. Plans E, H, I and J were discontinued and are not sold today.
How it’s traditionally been approached
Many people simply pay the new premium when a notice arrives. Others read the notice, call their carrier with questions, or ask a family member to help look at the numbers.
Some people shop around by requesting quotes from several companies for the same plan letter. Others ask a licensed agent or a State Health Insurance Assistance Program (SHIP) counselor to explain their choices. All of these are common and reasonable ways to handle a rate notice.
Switching has traditionally involved a few steps. Rules about when you can change, and whether a company can ask health questions (called medical underwriting), vary by state and change over time. Some people also consider moving to Medicare Advantage, which works differently, with its own strengths and trade-offs. Confirm current rules with Medicare.gov, your SHIP, or a licensed agent.
How the right licensed agent may help
A Medigap agent may help you make sense of a rate notice. A visit or call is usually a conversation. You share your current plan letter, your carrier, and how the premium has changed. The agent may explain what is behind the change and what choices could exist for you.
A Medigap agent may also compare carriers for the same plan letter and check for household or other discounts. Good questions to ask include: Will I need to answer health questions to switch? What happens to my current coverage if I change? How does this company handle future rate changes? Are there any discounts I could qualify for?
It also helps to ask about trade-offs. Medigap lets you see any provider nationwide that accepts Medicare, with no network or referrals, and predictable cost-sharing. Premiums are generally higher than some other options, drugs need a separate Part D plan, and routine dental, vision and hearing are not included. A Medigap agent may also talk through Medicare Advantage fairly, including its network rules and possible extra benefits. Call 1-800-MEDIGAP for more information.
The bigger picture
A higher premium can feel stressful, especially on a fixed income. Worry about bills can affect sleep, mood and how comfortable you feel about getting care. Taking time to understand your choices may bring some peace of mind.
Your health, budget and comfort with your doctors all matter together. Some people value keeping a plan that has served them well. Others prefer to explore changes. Neither choice is wrong. If you also want help finding care providers, Providers.plus may be one resource to explore.
Keep in mind
- Switching is not always possible or beneficial, and a company may be able to review your health history in some situations.
- Do not cancel your current policy until a new one is approved and in place.
- Rules on open enrollment, guaranteed issue, and birthday or anniversary windows vary by state and can change. Confirm them with Medicare.gov, your SHIP, or a licensed agent.
- This page is education only, not insurance, legal, tax or medical advice. 1-800-MEDIGAP is not connected with or endorsed by the U.S. government or the federal Medicare program.
Licensed agents
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Frequently asked questions
Why did my medigap rate increase?
Medigap premiums can rise for several reasons, including your age, the way your carrier sets prices, and general cost trends. Your notice or carrier may explain the method used. A Medigap agent may help you understand it. Call 1-800-MEDIGAP for more information.
Can I lower my medigap premium?
Possibly, but it is not guaranteed. Some people compare other companies selling the same plan letter, ask about discounts, or look at a different plan letter. Each option has trade-offs, so review them carefully before changing anything.
How do I compare medigap companies?
Start by comparing the same plan letter across companies, since the basic benefits are standardized in most states. Then look at how each company has handled rate changes and how it serves customers. A licensed agent or your SHIP can help you compare.
Do medigap companies offer household discounts?
Some companies offer a discount when two people in the same household are covered. Availability varies by company and state. Ask each carrier or a Medigap agent whether any discounts could apply to you.
Can I switch medigap plans anytime?
Often you can apply at any time, but acceptance may depend on your health and your state's rules. Some situations give extra protections, and these vary by state. Check current rules with Medicare.gov, your SHIP, or a licensed agent.
Is Plan H still available if I want to switch?
No. Plan H was discontinued and is not sold today, along with Plans E, I and J. Plans sold to people newly eligible for Medicare are A, B, D, G, K, L, M and N, plus high-deductible Plan G. Plans C and F are limited to people who became eligible before January 1, 2020.
Educational resource. 1-800-MEDIGAP shares general information and connects people with independent licensed agents. It is not professional advice. Talk with a qualified professional about your own situation.