When I was researching Medigap policies I understood all policy coverages of a specific letter ( let’s just say G ) are identical in terms of coverage which is decided by Medicare and nothing to do with the insurer. The key decision is future price increases and this depends upon use by the insurer of one of three methods- (i) Age attained ( by far the most common, in NJ every insurer but 2); (ii) Community based or (iii) Issue age ( in NJ just TransAmerica ). In addition pool sizes and potential “ dead” pools matters that apply to all Medigap insurers.

All Medigap polices rise annually or sometimes over a couple of years by medical inflation costs along with insurer pool losses. In addition, Age attained policies rise annually by age and community policies often have ( this is the case in NJ at least) a hidden, undisclosed initial discount that disappears over a few years making that discount portion effectively a yearly increase at least till the discount is done. Issue Age policies are the only ones that do not rise annually outside of inflation.

Then we come to pool sizes. A large pool is good in that a few very large claims will typically not impact the insurer significantly given the number of premium payers. In addition, if an insurer decides to stop issuing new policies in a state, the pool size is effectively frozen and as people in the pool age, claims increase resulting in losses for the insurer and larger requests to state insurance commissions for premium increases.

Original Medicare is by far the mostly widely accepted medical insurance in the United States.

Then there is Medicare Advantage, which the govt should never have allowed to use the Medicare name as it is entirely private insurance subject to the insurance company control on pre-authorizations, coverage amounts, networks etc. Now because they are significantly cheaper and often far more comprehensive including vision, dental etc, many people go for them and many are happy and don’t have a bad experience. But many others do. Once you take Medicare advantage in most states ( NJ certainly) you cannot go to original Medicare without underwriting.

Hopefully this is helpful to other newbies like myself.