Medigap Pricing Methods – Attained-Age, Issue-Age and Community-Rated

Medigap pricing methods can be categorized in one of three ways (as found on page 17 of the Choosing a Medigap policy booklet) – attained-age rated, issue-age rated, and community-rated. These differences are often discussed by insurance companies and agents, so it is important to understand what the terms mean, and more importantly, what they may mean to your Medigap rates in the future after you choose a plan.

Attained-age Medigap rates are based on your current age (i.e the age you have “attained”) and rates typically would go up as you get older based on your age or when you reach a birthday. Plans that are rated in this way will typically have lower rates initially when you sign up for a plan and will represent some savings (often significant savings) on the front end.

Issue-age Medigap rates are based on your age at the time that the policy is issued. Rates will be lower if you buy when you are younger. Premiums still go up over time, but it is just not based on your age. Instead, premium increases are based on inflation, claims experience and other factors.

Community-rated Medigap rates are based on the “community” (a certain geographic area) and are typically the same for everyone within that “community”, regardless of age. Just like issue-age rated plans, premiums still go up over time, just not based on your age. Instead, they go up for inflation and claims experience of everyone within that “community”.

So, what do Medigap pricing methods mean to you? First of all, a few facts about the different rating methodologies and things to keep in mind.

  • All Medigap rates are going to go up periodically. Most (regardless of Medigap pricing method) go up each year.
  • In some states, the vast majority of plans are attained-age rated, with only 1-2 exceptions to that.
  • In other states (for example, Georgia Medigap plans), the state restricts the companies to offer plans rates only with certain rating methodologies (i.e. no attained age in GA).
  • It is important to also consider the savings on attained-age plans. For example, if you can save $1000+ a year for the first 10 years of an attained-age plan, even if the rate eventually surpasses an issue-age plan, your already-pocketed savings on the front end are so significant, that may not matter.
  • Lastly, and most importantly, keep in mind that you can always change Medigap plans at any time and for any reason. In some states (for example: CA, OR, NY), this is a “guaranteed issue” right with no underwriting. In other states, you may have to answer general medical questions to be eligible to change. But in most cases, you can change plans to a lower-priced plan if your rate has gone up significantly.

Overall, it is advisable to have the assistance of an independent broker who can give you information about both current rates and typical future rates (i.e. history of rate stability) so you can make an informed choice on which company/plan is going to be best for you, both in the short term and into the future.

If you have questions about this information or Medigap pricing methods in general, you can contact us at 877.506.3378 or contact us online.

Medigap Plans – The Three Most Common Mistakes People Make

medigap plansMedigap plans are plans that fill in the gaps in Medicare Parts A & B. The plans are Federally-standardized and the way they work is relatively straight-forward, especially as compared to other types of insurance. However, it is important to make wise decisions when it comes to choosing and having a Medigap plan. There are three potentially critical mistakes that we often see when it comes to Medigap insurance.

  1. The first mistake, and this one is the most common, is neglecting to get a plan during your “open enrollment” period when you first turn 65 or go on Medicare for the first time. This mistake has its foundations in two common misconceptions – that you can get a plan any year during an annual open enrollment period or that you don’t have to “qualify” medically to get a plan. Both of these are inaccurate.First of all, your open enrollment is the 6 month period that coincides with when you sign up for Medicare Part B or turn 65. There is not an annual open enrollment period for Medigap plans, contrary to popular misconception. The annual open enrollment period that you hear referenced in advertising is the “annual election period” and it is for changing your Medicare Part D plan (or Medicare Advantage plan).The second misconception is that you do not have to qualify for a plan. I’ve heard many people say, especially since “Obamacare” passed, that they did not think that you had to qualify for insurance now. Unfortunately, that is not the case for supplemental types of insurance, like Medigap.So if you do not sign up for a plan when you are first eligible – many people think they are in good health now and will just wait until they “need” a plan – that can be a major mistake in regards to your future eligibility.
  2. The second significant mistake that we see made as far as Medicare supplement insurance is the way Medigap plans are chosen. Many people do not take the time to understand the standardization of plans and simply choose a plan because they have heard of it, it sounds good or a neighbor or family member has it.The reality is that over 90% of people are happy with their Medigap plans. The plans are very easy to use – they are standardized, pay claims automatically through the Medicare “crossover” system, and often cover everything that Medicare does not cover (Plan F). So, what’s not to like?However, just because your friend or neighbor is “happy”, that doesn’t necessarily mean they have the best plan. In fact, if they’ve had it for more than a year or two, they are probably paying too much for it. Rates often change annually and they can vary widely (have seen them range from $90/month to $300/month for the EXACT same coverage). Insurance companies “bank” on people keeping the same plan with Medigap plans, because of the overwhelming satisfaction people have with how their plan pays claims. However, it pays to understand the standardization both initially and later when you wish to re-evaluate – this way, you can compare based on price and company reputation (the two factors that matter) and make a wise and informed choice.
  3. The last of the three common mistakes people make with Medigap plans is the “set it and forget it” mistake, which is somewhat referenced in the paragraphs above. Medigap plans have rates that are consistently changing. There are new companies that enter the marketplace, market factors cause rate changes, and generally, rates just change over time and as you get older. The last thing you should do is make your one open enrollment decision and then never re-evaluate your plan and other options.
    What we generally recommend is comparing plans every two years. This way, you can find out how your plan compares rate-wise to other, equivalent-coverage options. If you can save money on another “like” plan and are in relatively good health, you can simply change to the new plan with a future effective. Then, once approved, you can cancel your old plan effective that same date. Keeping an eye on your rate to ensure you are not paying to much is definitely a wise thing to do when it comes to Medigap plans.

If you have any questions about this information or anything else regarding Medigap plans, you can contact us online at Secure Medicare Solutions or call us at 877.506.3378.