Checklist for Reviewing Medigap Plan G Rate Increases & Quotes

Disclaimer: This article is for educational and informational purposes only and is not legal, tax, or individualized insurance advice. Medigap rules, underwriting, and guaranteed issue rights vary by state and carrier and can change over time. Always confirm details with Medicare, your State Health Insurance Assistance Program (SHIP), your state insurance department, or a licensed Medicare insurance professional before making decisions.

1. Understand How Medigap Plan G Rate Increases Work #

Before you react to a Medigap rate increase, you need to understand why premiums go up and how your policy is priced. This context helps you decide whether your increase is reasonable or a sign to start shopping Medigap carriers.

Key points about Medigap Plan G pricing:

• Benefits are standardized

  • Plan G coverage is the same no matter which company sells it.
  • A Plan G from Carrier A must cover the same medical services as Plan G from Carrier B, as defined by federal rules (except in Massachusetts, Minnesota, and Wisconsin, which have different standardized plans).

• Premiums and rate increase patterns are NOT standardized

  • Each carrier sets its own premium, subject to state approval.
  • Companies use different pricing methods and can have very different rate histories.

Common Medigap Pricing Methods #

Your Plan G likely uses one of three pricing structures. This affects how and when you see increases:

1. Community-rated (no-age-rated)

   • Everyone in the area pays the same base premium, regardless of age.
   • Increases usually come from inflation, claims experience, or company adjustments, not your birthday.

2. Issue-age-rated

   • Your premium is based on your age when you first buy the policy.
   • It does not increase because you get older, but it can still rise due to inflation, claims, or company changes.

3. Attained-age-rated

   • Your premium is based on your current age and usually increases as you get older.
   • You may see both age-based increases and across-the-board rate increases.

Check your policy or welcome packet for the pricing method, or ask your agent or carrier. This helps you understand whether your recent Medigap rate increase is a one-time adjustment or part of a predictable pattern.

Why Medigap Plan G Premiums Increase #

Common reasons for Medigap rate increases include:

• Rising health care costs in your area
• Higher-than-expected claims for your age group or plan block
• Administrative and operational costs for the insurer
• Your birthday (for attained-age policies)
• Changes in state rules or required benefits (where applicable)

Knowing the “why” behind your increase helps you decide whether to stay put, negotiate, or start comparing Medigap quotes.

2. Step 1: Confirm Your Current Plan G Coverage and Premiums #

Start your Plan G premium review by getting a clear picture of what you have now. You can’t judge new quotes accurately unless you know your current numbers and benefits.

Checklist: Gather Your Current Policy Details #

Pull together:

• Your Medigap Plan G ID card
• Most recent premium statement or bank draft record
• Original policy or welcome kit
• Latest rate increase letter or renewal notice

From these documents, confirm:

• Carrier name (including any recent name changes or acquisitions)
• Exact plan (Plan G; note if it’s a high-deductible Plan G)
• Current monthly premium
• Premium payment method (monthly, quarterly, annually)
• Any household, EFT, or other discounts
• Policy effective date (when your Plan G first started)

Write this down in a simple table or worksheet:

• Current carrier: ______
• Plan type: Standard G / High-deductible G
• Current monthly premium: $______
• Discounts applied: ______
• Policy start date: ______

This becomes your baseline for comparing Medigap carriers and quotes.

3. Step 2: Evaluate Your Medigap Rate Increase Notice #

Once you know your current numbers, look closely at your rate increase notice. This is where you identify how big the change is and when it takes effect.

Checklist: Read Your Rate Increase Letter #

Look for:

• New premium amount
  • What will your monthly premium be after the increase?
• Effective date of the new premium
  • When does your payment actually go up?
• Percentage increase
  • If it’s not listed, calculate it:
    • (New premium – Old premium) ÷ Old premium × 100
• Reason(s) for the increase
  • Some letters list general reasons (claims experience, age, etc.).

Example:

• Old premium: $165/month
• New premium: $189/month
• Increase: $24/month
• Percentage: ($24 ÷ $165) × 100 ≈ 14.5%

Compare to Past Increases #

Look back at:

• Last 2–3 years of premiums (bank statements, letters, or online account)
• Any previous rate increase notices

Ask yourself:

• Are your increases getting larger each year?
• Is this year’s increase bigger than the state average for Medigap (you can often find this via your state insurance department or SHIP)?
• Is your policy attained-age and also getting an across-the-board increase?

If you see a pattern of steep or frequent increases, it’s a strong signal to start shopping Medigap carriers and comparing Plan G quotes.

4. Step 3: Review Your Health, Budget, and Coverage Needs #

Before you chase lower premiums, make sure a change aligns with your health and budget needs. A slightly higher premium with more stability or easier underwriting can sometimes be the better choice.

Health Status Checklist #

Consider your:

• Current diagnoses and medications
• Recent hospitalizations or surgeries
• Upcoming planned procedures
• History of chronic conditions (heart disease, COPD, diabetes, cancer, etc.)

Why this matters:

• Many Medigap moves outside of guaranteed issue periods require medical underwriting.
• Certain conditions or recent treatments can lead to denials or higher rates.
• If you’re in excellent or stable health, you may have more leverage to qualify for a better premium with another carrier.

Budget and Risk Tolerance Checklist #

Review:

• Your monthly income (Social Security, pension, savings withdrawals)
• Other health costs:
  • Part B premium
  • Part D prescription premium and copays
  • Dental/vision or other supplemental policies
• How much premium increase you can realistically absorb over the next 2–3 years

Ask:

• Does your new premium threaten your ability to pay other essential bills?
• Would a slightly lower premium with a less stable rate history be worth the risk?
• Are you comfortable going through underwriting and potential denial in order to save?

This step helps you define your goals: lower premium at all costs, better long-term stability, or keeping your current plan unless the increase crosses a certain threshold.

5. Step 4: Compare Medigap Plan G Quotes and Carrier Options #

Now you’re ready to shop. Because Plan G benefits are standardized, your focus should be on price, rate history, underwriting requirements, and service.

Where to Get Medigap Plan G Quotes #

You can:

• Contact a licensed independent Medicare insurance agent who represents multiple carriers
• Use online quote tools that show multiple companies (verify they’re up to date and licensed in your state)
• Call carriers directly for rates and underwriting guides
• Check your state insurance department or SHIP for consumer rate comparison tools, if available

Checklist: Information to Request for Each Quote #

For each carrier and Plan G quote, gather:

• Monthly premium at your current age
• Plan type:
  • Standard Plan G or High-Deductible Plan G
• Discounts:
  • Household/spousal
  • EFT (automatic bank draft)
  • Non-smoker or other discounts
• Pricing method:
  • Community-rated, issue-age, or attained-age
• Rate increase history:
  • Average annual increases in your state or area for the past 3–5 years (if available)
• Underwriting requirements:
  • Health questions, look-back periods, conditions that are automatic declines

Create a comparison table with:

• Current Plan G vs. Carrier A vs. Carrier B vs. Carrier C
• Monthly premium, pricing method, and any known rate trends

Remember: the lowest premium today isn’t always the best choice if the carrier has a record of large, frequent Medigap rate increases.

6. Step 5: Check Underwriting Rules and Guaranteed Issue Rights #

Before you decide to switch, you must understand whether you’ll have to answer health questions and whether you’re in a guaranteed issue situation.

Rules vary widely by state and carrier, so always confirm your specific situation with a licensed professional or SHIP counselor.

Common Situations With Guaranteed Issue Rights #

You may have federal or state guaranteed issue rights in scenarios such as:

• You are in your Medigap Open Enrollment Period (the 6 months starting when you are 65+ and first enrolled in Part B).
• Your employer group coverage or union plan that supplements Medicare is ending.
• Your Medicare Advantage plan is leaving your area, stops contracting with Medicare, or you move out of its service area.
• Your Medigap carrier goes bankrupt or misleads you (limited situations).
• Certain trial rights, such as trying a Medicare Advantage plan for the first time and deciding to go back to Original Medicare within a specific period.

In these cases, you may be able to get certain Medigap plans (often including Plan G in some states, or plans available to new enrollees) without medical underwriting.

State-Specific Special Rules #

Some states have:

• Birthday rules (e.g., you can switch to another Medigap plan of equal or lesser benefits around your birthday without underwriting).
• Anniversary rules (switching around the anniversary of your existing Medigap policy).
• Year-round guaranteed switching to equal or lesser coverage.
• Unique standardized plan structures (MA, MN, WI).

Because these rules vary, check:

• Your state insurance department website
• Your local SHIP office
• A licensed Medicare specialist familiar with your state

Underwriting Checklist If You Don’t Have Guaranteed Issue #

If underwriting is required:

• Ask each carrier:

  • What health conditions are automatic declines?
  • How far back do they look at medical history (e.g., 2 years, 5 years)?
  • How do they treat recent hospitalizations or surgeries?
  • Are certain medications red flags?

• Make sure you:

  • Answer all questions honestly and completely
  • Understand you can be denied and may need to stay with your current carrier

Do not cancel your existing Medigap Plan G until your new policy is approved, issued, and effective.

7. Step 6: Verify Carrier Financial Strength and Member Experience #

With coverage standardized, the carrier itself becomes a major factor. You want a company that is financially stable and treats policyholders well.

Checklist: Carrier Financial Strength #

Research:

• Independent rating agencies, such as:
  • A.M. Best
  • Standard & Poor’s
  • Moody’s
  • Fitch

Look for:

• Strong or stable ratings (e.g., A-, A, A+ from A.M. Best, where available)
• How long the company has been active in the Medigap market
• Whether they’re known for frequent rate filings in your state

Your state insurance department may also publish information on:

• Complaint ratios
• Rate filing histories
• Enforcement actions

Checklist: Member Experience and Service #

Consider:

• Customer service hours and availability
• U.S.-based vs. outsourced call centers (if that matters to you)
• Online tools:
  • Member portals
  • Electronic premium payments
• Reviews and consumer feedback:
  • From state insurance department data
  • From SHIP counselors’ experience
  • From independent agents’ experience with claims and service

One or two online reviews shouldn’t drive your decision, but consistent patterns of billing issues, poor communication, or slow claims handling are warning signs.

8. Step 7: Calculate Total Costs and Decide Whether to Switch #

Now combine everything: premiums, rate history, discounts, and stability. Your goal is to compare total expected costs and risk, not just today’s premium.

Checklist: Compare Total Costs #

For each option (including staying put), estimate:

1. Annual premium
   • Monthly premium × 12
2. Likely future increases
   • Based on the carrier’s historical rate trends and pricing method
3. Out-of-pocket exposure
   • With Plan G, you pay the Part B deductible each year plus any non-covered services (e.g., dental, routine vision).
   • If you’re considering high-deductible Plan G, factor in the annual deductible amount.
4. Non-financial factors
   • Underwriting risk (chance of denial)
   • Carrier stability and service
   • Ability to switch again later if needed

Example Comparison #

• Option 1: Stay with current carrier

  • New premium: $189/month = $2,268/year
  • Recent increases: 10–15% per year
  • No underwriting needed

• Option 2: Switch to Carrier A

  • New premium: $165/month = $1,980/year
  • Rate history: 3–5% average annual increase
  • Requires underwriting (you’re in good health)

In this example, Carrier A saves about $288/year and may have more stable increases, but you must be comfortable with underwriting risk and the new carrier’s profile.

Decide whether:

• The savings are significant enough for your situation
• You’re willing to accept underwriting and potential denial
• Future rate stability looks better with the new carrier

9. Step 8: Enroll in a New Medigap Plan G and Avoid Coverage Gaps #

If you decide to switch, timing and paperwork are critical. You want a seamless transition with no lapse in coverage.

Enrollment Checklist #

1. Apply for the new Plan G first

   • Complete the application with your chosen carrier or agent.
   • Answer all health questions honestly.
   • Provide your Medicare number and Part A/B effective dates.

2. Confirm underwriting and approval

   • Wait for a formal approval notice from the new carrier.
   • Verify:
     • Plan type: Plan G
     • Monthly premium
     • Effective date of coverage

3. Coordinate effective dates

   • Aim for your new Plan G to start the same day your old one ends.
   • Common practice:
     • New policy effective date on the first of a month.
     • Cancel the old policy only after the new one’s effective date is confirmed.

4. Cancel your old Medigap policy in writing

   • Follow your current carrier’s instructions:
     • Some require a signed cancellation form or written letter.
   • Keep:
     • A copy of your cancellation letter
     • Proof of delivery (certified mail, email confirmation, etc.)

5. Update premium payments

   • Stop automatic payments to the old carrier once coverage ends.
   • Set up EFT or other payment for the new policy.
   • Watch your bank statements to confirm the changes.

Avoiding Common Mistakes #

• Don’t cancel your current Medigap Plan G before new coverage is approved and effective.
• Don’t assume you have guaranteed issue rights without verifying them.
• Don’t ignore your Part D or other coverage—those are separate from Medigap and do not automatically move with you.

10. Summary: Using This Medigap Plan G Checklist Each Renewal #

Each time you receive a Medigap rate increase notice, use this checklist to decide whether to stay or shop:

1. Understand your pricing method and why rates are rising.
2. Confirm your current coverage and premiums so you know your baseline.
3. Evaluate the increase notice and compare it with past years.
4. Review your health, budget, and coverage needs to set your goals.
5. Compare Medigap Plan G quotes from multiple carriers, including pricing method and rate history.
6. Check underwriting rules and guaranteed issue rights based on your state and situation.
7. Verify carrier strength and member experience using independent ratings and complaint data.
8. Calculate total costs and risk, then enroll in a new Plan G only when it clearly benefits you, making sure you avoid coverage gaps.

Plan availability, pricing, and Medigap rate increase patterns change over time. Always confirm current details with Medicare, your SHIP office, your state insurance department, or a licensed Medicare insurance professional before you switch.

FAQ #

How often do Medigap Plan G premiums increase? #

Medigap Plan G premiums are typically reviewed once per year, but the timing and amount of increases vary by carrier, state, and pricing method. Some companies may go several years with modest changes, while others file increases more frequently or in larger amounts.

Your rate can also change when you enter a new age band on an attained-age policy or if your carrier adjusts discounts. Check your renewal notice and your carrier’s past rate history to understand their pattern.

When should I shop new Medigap carriers after a rate increase? #

You should start comparing Medigap quotes as soon as you receive your rate increase notice. This gives you time to:

• Review your options
• Complete underwriting if required
• Coordinate effective dates to avoid gaps in coverage

Waiting until right before your new premium takes effect can limit your choices, especially if there are underwriting delays or you need to gather medical records.

Can I change Medigap Plan G carriers without medical underwriting? #

In some situations, yes. You may be able to change carriers without underwriting if you:

• Are in your Medigap Open Enrollment Period
• Qualify for federal guaranteed issue rights (for example, your Medicare Advantage plan leaves your area)
• Live in a state with special switching rules, such as birthday or anniversary rules that allow changes to equal or lesser coverage

Outside of these situations, many moves to a new Medigap carrier will require medical underwriting. Because rules vary by state and carrier, confirm your options with SHIP or a licensed Medicare insurance professional.

Do all Medigap Plan G policies offer the same coverage? #

Yes. In most states, Medigap Plan G benefits are standardized by federal law. This means:

• The medical coverage—what Plan G pays after Original Medicare—must be the same regardless of which company sells it.
• Differences between carriers are mainly in premium, rate increase patterns, underwriting, discounts, and service.

The main exceptions are Massachusetts, Minnesota, and Wisconsin, which have different standardized Medigap structures. In those states, comparable benefits may be labeled differently.

Will switching Medigap carriers affect my doctors or Medicare coverage? #

Switching Medigap carriers does not change your Original Medicare benefits or provider access. You keep:

• Your red, white, and blue Medicare card
• The same freedom to see any doctor or hospital that accepts Medicare

However, you should:

• Make sure your new Medigap Plan G is approved, issued, and active before canceling the old policy.
• Confirm your Part D prescription drug plan and any other coverages remain in place, as they are separate from Medigap.

As long as your new Medigap policy is correctly set up, your doctors and Medicare coverage should not be affected by changing carriers.