We have a friend in Polk County, FL (Lakeland), the Medicare supplement rates vary literally from one side of town to the other.
Her premiums are double ours here in KY. Ditto for my brother in Volusia County, FL.
When we got our supplements 9 years ago the BCBS agent told me that if you went across the river to IN, the rates were 20% higher.
Ours are almost double from the first year. Probably will pass that as soon as we get our 2026 notice.
Between that and our massive property tax increases (43% in 2024), I can’t afford to live another 10 years.
These differences are based on medicare reimbursement per zone. And it also can be different from one provider to the next.
It doesn’t explain the massive increases, but the difference in zone can be based on the income of the area, and the amount of customers who have a non-government insurance.
Soon, you will see a growth in outpatient surgical and treatment centers. This is done by larger health groups because they are not “first contact” centers. In essence, you could have a surgical and diagnostic center that is the second step in treatment. And...no one is going there without insurance. It means the health group is not dealing with the staggering levels of bad debt that hospital systems are.
The bad debt is what is killing hospital systems. My wife works for a healthcare provider. I listen to some of their higher level admin meetings (she works in the kitchen and I have my coffee in the next room). The amount of uninsured and the amount of bad debt for a little hospital is in the millions each year. In order to stay open, they have to spread those costs across people who have the ability to pay. Combine that with huge start up and insurance costs for providers and it is going to drive us into a two tier system: One private, where you get good healthcare...and the return of the “free clinic” care of the 60’s.
I don’t know where this is all going...but I would suggest everyone get fit, eat well, and exercise. Because you do not want to get trapped in “the system.”
LISTEN UP.
The details of the OP’s layout notwithstanding, there is another far more intrusive problem.
Part D plans are disappearing. The Inflation Reduction Act ended several $Billion in subsidy that Medicare was sending to Part D plans. And some, most, went through their formulary and started extracting drugs they would cover.
They face that subsidy cut off. They are addressing it with sharp premium increases, ending coverage of certain drugs, or closing their doors altogether.
At this point Medicare Advantage enters the chat. Yes, there are horror stories about Advantage. How rare they are we are going to ignore because . . . the standard recommend now looks like this:
Your Part D plan has closed or is not covering a drug you need? Well, kill Medigap and its attendant Part D plan, get an Advantage plan whose built-in drug coverage addresses the specific drug you need AND, AND, AND add to the Advantage plan a Hospital Indemnity Policy.
This approach attacks the Advantage disaster scenarios. The standard Advantage copay for being in the hospital is about $500/night copay for nights 0-5. Beyond 5 the copay is $0/night. Obviously a long stay hammers the Advantage policy, so they have procedures focused on getting you booted out of the hospital even if only for 1 night (which restarts the 0-5 clock).
The Hospital Indemnity add-on policy erases this scenario. It pays for your hospital stay and the Advantage people are no longer facing bankruptcy from your long hospital stay. (Indemnity plans price about 40% of the Medigap premium you erased when you replaced Medigap/Part D with Advantage).
So heads up on this. Part D plans are disappearing or abusing you. Advantage plans + Indemnity are the response.