Do Medigap plans vary from state to state?

Asked by: Dr. Filiberto Hills  |  Last update: October 13, 2023
Score: 4.1/5 (59 votes)

Medigap policies are standardized by the federal government, which means that Plan A, for example, will have the same benefits no matter where you live in the U.S. However, the premium you pay for your Medigap policy may differ from state to state.

Are Medicare supplements the same in all states?

State-Specific Medicare Supplement Rules

Medigap plans are standardized across most states, meaning they offer the same benefits. The exceptions are Wisconsin, Minnesota and Massachusetts.

Which states have lowest Medigap rates?

The average monthly premium for Medicare Supplement plans varies depending on the state. The average monthly premium for Medigap policies was lowest in Wisconsin, Hawaii, and Iowa at around $102 monthly.

Are all Medigap plans the same?

Insurance companies may offer up to 10 different Medigap policies labeled A, B, C, D, F, G, K, L, M and N. Each lettered policy is standardized. This means that all policies labeled with the same letter have the same benefits, no matter which company provides them or their price.

Are Medigap policies only standardized in 3 states?

Because the Medigap plans are standardized, an A or F plan sold by one insurer covers the same things as an A or F plan from another insurer. Medigap plans are consistent in all but three states: Massachusetts, Minnesota and Wisconsin have their own standard policies.

How Will Moving States Impact my Medicare Coverage?

28 related questions found

What 3 states allow year round enrollment in Medigap?

In addition to the states that have specific, annual open enrollment periods, there are a few states that have year-round open enrollment periods for people on Medigap plans. As of the time of this article, there are three states that offer this: Connecticut, New York, and Vermont.

Do Medigap premiums increase with age?

Attained-Age Plans

The younger you are at enrollment, the lower your premium. But your premium rates increase as you get older. For example, if you're 65 years old, your premium for a particular Medigap plan might be $130, but the same plan may cost $170 when you're 75 years old.

What is the most expensive Medigap plan?

Because Medigap Plan F offers the most benefits, it is usually the most expensive of the Medicare Supplement insurance plans. However, this may not always be the case, and you should shop around to find the best plan option for you.

What percentage of people get Medigap?

About 23% of Medicare's 65.1 million beneficiaries are enrolled in a Medigap plan. While these supplemental insurance policies either partially or fully cover cost-sharing associated with basic Medicare (Part A hospital coverage and Part B outpatient care), the monthly premiums can be pricey.

Why is Medigap so expensive in Florida?

Because of the higher percentage of seniors in the state, insurance carriers have to charge higher premiums to be able to afford to pay for your coverage. Fortunately, there are a ton of Medigap plans in Florida, so you have plenty of options to compare to find the most cost-effective plan.

Is Medigap being phased out?

The Medicare Access and CHIP Reauthorization Act of 2015 states that, after January 1, 2020, insurance companies can no longer offer any new Medigap plan that covers the Original Medicare Part B deductible. On that date, insurance carriers cannot offer Medigap plans C and F to new enrollees.

Do all Medigap policies cost the same?

The cost of Medigap policies can vary widely. There can be big differences in the premiums that different insurance companies charge for exactly the same coverage. As you shop for a Medigap policy, be sure to compare the same type of Medigap policy, and consider the type of pricing used.

Who is the largest Medicare Supplement provider?

AARP/United Health Group has the largest number of Medicare Supplement customers in the country, covering 43 million people in all 50 states and most U.S. territories. AARP licenses its name to insurer UnitedHealthCare, which helps make these policies so popular.

Why does zip code matter for Medicare?

Why does my zip code matter for Medicare? Your zip code matters for Medicare because plan options change depending on your location. Also, Medicare Advantage plan networks depend on the private insurance company providing care to each client. Zip code is vital in terms of Medicare program eligibility.

Why are Medigap plans priced differently?

Age: Medigap premiums are often based on the age of the enrollee. Older individuals may be charged more for a Medigap plan than younger individuals because they are considered to be at a higher risk for medical expenses. Location: The cost of Medigap plans can vary depending on the state in which the individual lives.

Is Medigap or advantage better?

How do I choose between Medicare Advantage and Medigap? Consider your priorities, like budget, choice, travel, and health conditions. While Medicare Advantage can be more affordable for people with long term health issues, Medigap gives you flexibility and choice by expanding your network.

Do most people have Medigap or Medicare Advantage?

Nine in 10 people with Medicare either had traditional Medicare along with some type of supplemental coverage (51%), including Medigap, employer-sponsored insurance, and Medicaid, or were enrolled in Medicare Advantage (39%) in 2018 (Figure 1).

What is Medigap changing for 2023?

If you get the high‑deductible option, you must pay for Medicare‑ covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2023 before your policy pays anything, and you must also pay a separate deductible ($250 per year) for foreign travel emergency services.

Does income affect Medigap premiums?

Medigap's premium stays the same regardless of your income. This is good news for those who make a lot and bad news for those on a fixed income.

Can I change Medigap plans anytime?

You can apply for a new Medigap plan or apply to change your coverage at any time, even after your Medigap initial enrollment period.

What is Medigap out-of-pocket limit 2023?

The 2023 out-of-pocket (OOP) limits for Medigap plans K & L are $6,940 and $3,470, respectively. These increases in the limits are based on estimates of the United States Per Capita Costs (USPCC) of the Medicare program developed by the Centers for Medicare & Medicaid Services (CMS).

Does Medicare pay differ from state to state?

A federal agency called the Centers for Medicare & Medicaid Services runs Medicare. Because it's a federal program, Medicare has set standards for costs and coverage. This means a person's Medicare coverage will be the same no matter what state they live in.

What are some reasons someone would want to switch to a different Medigap policy?

You may want to change your Medigap policy, if:
  • You're paying for benefits you don't need.
  • You need more benefits.
  • You want to change insurance companies.
  • You want a policy that costs less.