If you opened your renewal letter this year and felt your stomach drop, you're not alone. Medigap premium increases have been steeper than usual across most carriers, and a lot of folks in the Sandhills are asking the same question: do I just have to live with it?
The short answer is no. There's something about how Medigap plans work that almost nobody talks about, and once you understand it, the playing field changes.
Medigap plans are standardized. All of them.
Here's the part that surprises most people. The federal government, through CMS, requires every Medigap plan to be standardized by letter. Plan A is Plan A. Plan G is Plan G. Plan N is Plan N. The benefits are identical no matter which insurance company sells it.
That means if you have Plan G with one carrier and you switch to Plan G with a different carrier, your coverage is exactly the same. Same Part A coinsurance coverage. Same Part B coinsurance. Same skilled nursing facility coverage. Same foreign travel emergency benefit. Same everything.
The carriers can compete on three things: price, financial stability, and customer service. They cannot compete on benefits, because the benefits are set by federal law.
So why do prices vary so much?
A few reasons.
Carriers price based on their own risk pools, their own administrative costs, and their own marketing budgets. A company that's been in your zip code for 30 years and has an aging book of policyholders may be raising rates faster than a newer entrant trying to grow market share. A national carrier with heavy advertising spend bakes that into the premium. A regional carrier with lean operations may price lower.
The result is that two companies can offer the identical Plan G in the same zip code with monthly premiums that differ by 30, 50, sometimes 80 dollars. For the same coverage. Same doctors. Same everything.
There's no enrollment window for switching Medigap
This catches a lot of people off guard. Open enrollment in October through December applies to Medicare Advantage and Part D. It does not apply to Medigap.
Medigap is year-round. You can shop for a new carrier in January, June, or any other month. Your switch isn't tied to the calendar. The only gating factor is whether the new carrier accepts your application based on health questions.
So if your renewal letter just arrived and the number jumped, you don't have to wait until fall to do something about it.
What about your doctors?
This is the question we get most often, and the answer is the part that catches people off guard.
Medigap plans do not have networks. Any doctor who accepts Original Medicare accepts every Medigap plan from every carrier. Your cardiologist does not care which company is on your Medigap card. Your primary care doctor does not care. The hospital does not care. They bill Medicare, Medicare pays its share, then the bill goes to your Medigap carrier for the rest.
When you switch Medigap carriers, nothing about your medical care changes. You see the same doctors. You go to the same hospitals. You fill prescriptions the same way (your Part D plan is separate and stays put unless you change it).
What's involved in switching, in plain English
Outside of your initial enrollment window or a guaranteed issue situation, switching Medigap in North Carolina usually means medical underwriting. The new carrier asks health questions and decides whether to accept your application.
NC is not one of the states with an annual "birthday rule" or guaranteed issue switching window. So health questions matter here. But that doesn't mean you can't qualify. Most people can, including people managing common conditions.
A good independent agent will walk you through the carrier health questions before you ever submit an application. We can usually tell within a few minutes whether you're likely to qualify with a particular carrier. If you're not, we don't waste your time. If you are, we shop the rate and lay out the options.
If you don't qualify with anyone, you stay where you are. There's no penalty. There's no record that you tried.
How much can you actually save?
It varies. We've seen people save 50 dollars a month. We've seen people save 200 dollars a month. The savings depend on what plan you have, who your current carrier is, how long you've been with them, and your zip code.
The pattern we see most often is folks who enrolled five or more years ago with a big-name carrier. Those rates have crept up year after year, and the gap between what they're paying and what newer competitors charge has grown wide. A comparison takes 15 minutes and almost always uncovers something worth knowing.
When does it make sense to compare?
Anytime, but especially:
- You just got a renewal letter with a rate increase
- You've been with the same carrier for three or more years
- You're paying more than $200 a month for Plan G or more than $150 for Plan N
- You've never compared your rate against the rest of the market
Medigap is not tied to Medicare's annual enrollment period. You can switch any time of year, as long as a carrier will accept you.
What to do next
If you want to see what you could be paying, we put together a free comparison tool that takes about 30 seconds to fill out. We shop your current plan letter against the carriers we work with and send you a clear breakdown.
We're a local independent agency in Aberdeen. We work with multiple Medigap carriers and we get paid the same regardless of which one you choose. There's no pressure, no obligation, and no cost to find out.
Or call us directly at (910) 994-6464. Ask for Blake or anyone on the team.