Medicare Supplement Plans by State

The ten Medigap plan letters are set by federal law, so a Plan G in Ohio pays exactly what a Plan G in Oregon pays. What changes at the state line is how that policy is priced, who must be allowed to buy it, and which companies are willing to sell it.

That is why the state you live in matters more than the company brochure. The same plan letter can cost twice as much in one state as another, and a health history that is irrelevant in New York can end an application in Texas.

Insurers in most states may use attained-age, issue-age or community rating. Attained age means the premium rises as you grow older, issue age fixes the price at purchase, and community rating spreads the cost evenly across every policyholder regardless of age.

New York, Connecticut, Massachusetts, Maine, Vermont and Washington require community rating, which is why their premiums start higher and stay flatter. Everywhere else, ask which method a quote uses before you compare two prices that may not be measuring the same thing.

Your six-month Medigap open enrollment period is federal and applies everywhere: insurers must sell you any policy they offer at their best rate. After it closes, most states allow medical underwriting, and a diagnosis can mean a decline or a permanent surcharge.

A handful of states add an annual birthday rule, letting you change carriers for the same or a lesser plan letter without health questions. A few others guarantee issue year round. Everywhere else, the first purchase is the only unrestricted one you get.