What it is
A Medigap premium is the monthly amount you pay a private insurance company for a Medigap policy. It is separate from what you pay for Medicare Part B. The policy helps with some costs Original Medicare does not pay.
Medigap plans are standardized by letter. A Plan G from one company covers the same basic benefits as a Plan G from another. In Massachusetts, Minnesota and Wisconsin, Medigap is standardized differently. Even with matching benefits, the price can vary from company to company.
Several things can affect the price. These often include the plan letter, your state or ZIP code, your age, tobacco use, and sometimes gender or household discounts. Each company decides which factors it uses, within what state rules allow.
1-800-MEDIGAP is an independent, privately run educational site. It is not Medicare.gov, CMS, Social Security or any government agency.
How it’s traditionally been approached
Insurers have traditionally used three pricing methods. Community-rated (sometimes called no-age-rated) premiums are generally not based on your age. Issue-age-rated premiums are based on the age you were when you bought the policy. Attained-age-rated premiums are based on your current age and may rise as you get older.
Each method has trade-offs. A policy that starts lower may rise more over time, while one that starts higher may stay steadier in terms of age. Premiums can also rise because of inflation or rising healthcare costs, no matter which method is used.
Many people compare plans by looking at both the starting premium and how the company has handled rate changes in the past. Some also compare plan letters, such as Medigap Plan G and Medigap Plan N, which have different cost-sharing designs. Rules on when you can buy, and whether a company can review your health, vary by state and change over time.
How the right licensed agent may help
A Medigap agent may help you see how different companies price the same plan letter. Licensed independent agents can often explain which pricing method each company uses. This may make side-by-side comparisons clearer.
A conversation is usually a relaxed, informational chat. You might be asked about your state, your age, your current coverage and your budget comfort. Good questions to ask include: Is this premium community-, issue-age- or attained-age-rated? How have rates changed in the past? Are there household or other discounts?
If you already have a policy, an agent may also review your current premium and compare it with other options. Whether you can switch can depend on your state and health history, and acceptance is never guaranteed. Call 1-800-MEDIGAP for more information.
The bigger picture
Premiums touch more than a budget line. A monthly cost that feels steady can bring peace of mind, while surprise increases can add stress. Thinking about how your costs may change over the years can help you choose with more confidence.
Taking time to understand pricing may help you feel more in control of your health and finances. If you also look for care providers, Providers.plus may be one place to explore. No single approach fits everyone, and Medicare Advantage is also a valid choice for many people.
Keep in mind
- Medigap is not Medicare. Official information is at Medicare.gov, and your State Health Insurance Assistance Program (SHIP) offers free local help.
- Medigap often has higher monthly premiums than some Medicare Advantage plans, but it lets you see any provider nationwide that accepts Medicare, with no network or referrals. Medicare Advantage may offer lower premiums, an annual out-of-pocket maximum and extra benefits, with networks and prior authorization as trade-offs.
- Medigap does not include drug coverage or routine dental, vision or hearing. You would need a separate Part D plan for drugs.
- Enrollment rules, medical underwriting and guaranteed issue rights vary by state. Confirm current rules with Medicare.gov, your SHIP or a licensed agent.
Take the next step
- Talk with a Medigap agent ↗Jeff Cline on contacts.plus — a person, not a call center.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Call 1-800-MEDIGAP for more information
Frequently asked questions
How are medigap premiums priced?
Private insurers set Medigap premiums using methods such as community-rated, issue-age-rated or attained-age-rated pricing. Plan letter, state, age and other factors may also matter. Each company decides within its state's rules.
What is the difference between community-rated and attained-age-rated Medigap?
Community-rated premiums are generally not based on your age. Attained-age-rated premiums are based on your current age and may rise as you get older. Each has trade-offs, so it helps to ask how a policy is rated.
Why do Medigap premiums differ between companies for the same plan?
Benefits for a plan letter are standardized, but companies price them differently. Differences can come from the pricing method, the insurer's costs, discounts and your state. Massachusetts, Minnesota and Wisconsin standardize differently.
Can my Medigap premium go up over time?
Yes, premiums can rise over time. Increases may come from your age, depending on the pricing method, or from general rising healthcare costs. Asking about a company's rate history may help you compare.
Do Medigap Plan G and Plan N cost the same?
No, they are priced separately and often differ. Plan N has a different cost-sharing design than Plan G. Which one fits can depend on your budget and how you use care. Call 1-800-MEDIGAP for more information.
Can a Medigap agent help me review my current premium?
A Medigap agent may be able to explain your current pricing method and compare other options. Whether you can switch depends on your state and health history, and acceptance is not guaranteed. Confirm rules with Medicare.gov, your SHIP or a licensed agent.
Educational resource. 1-800-MEDIGAP shares general information and connects people with independent licensed agents. It is not professional advice. Talk with a qualified professional about your own situation.