Medigap Rates – Who Determines Them and Why Do They Go Up?

Medigap rates change over time. That is, quite simply, a fact. Some companies will be more stable than others – some plans are more stable than others. But overall, all rates, regardless of the company, plan or where you live will change. The important thing is understanding how those rate changes work, when they occur and why they occur. This allows you to minimize the effect rate increases have on your pocketbook and know when to make changes to your plan if necessary.

First of all, rate increases are always approved by the state departments of insurance. Your state is responsible for screening both the increase itself, as well as the size and administration of that increase (i.e. when it occurs). You cannot be singled out for an increase. One of the most common questions that we receive is… “I have not been to the doctor’s office but once all year, so why is my rate going up?” Unfortunately, that is not the way insurance works. Your rate goes up based on the claims experiences of everyone who has that company in your geographical area (usually in your state). So, your rate, when it goes up (not IF, but WHEN) will go up based on a percentage. For example, if your Plan F rate is $100 and the company has a 6% increase on Plan F rates, your new rate will be $106. The company is required to give you advance notice of any rate changes – 30 days in most states.

There are many things that differentiate the increases that companies will have. Besides geographical and claims experience factors, there is also the factor of which plan you have. In other words, most companies have different size increases on different plans. In general, a plan that is not Federally-required to be offered on a “guaranteed issue” basis in certain situations will be more stable over time. The plans that are required to be offered in “guaranteed issue” situations (i.e. losing employer coverage or Advantage plan coverage) are A, B, C, F, K and L. The other four plans would be, historically speaking, more stable over time due to NOT having to be offered in “guaranteed issue” situations.

Now, when your rate is going to go up, you do have some recourse, particularly if you are in relatively good health and are getting a significant increase. There are NO enrollment periods for Medigap plans (When is the Medigap enrollment period?) so you can change plans any time that your rate goes up. It is always advisable to re-evaluate your rates against those of other plan options when your rate goes up.

If you have questions about this or would like a rate quote comparison for the plans available for your age and zip code, please call us at 877.506.3378 or contact us on our website at Medigap quotes from Medicare-Supplement.US.

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