Medicare Supplement

Same Medigap Benefits, Different Bill: The 3 Pricing Rules

GOODYEAR, Ariz. — If you've shopped for a Medicare Supplement (Medigap) policy, you've probably noticed something confusing: two policies can offer the exact same benefits, yet the price and the way that price changes over time can look very different. That's not a mistake. It's the pricing method.

Medigap benefits are standardized by the federal government — a Plan G is a Plan G no matter who sells it. But how insurers price those plans is not standardized. There are three methods, and knowing which one you're being offered can help you avoid a surprise down the road.

Method 1: Community-rated (also called "no-age-rated")

With a community-rated policy, everyone who buys the same plan from the same insurer pays roughly the same premium, regardless of age. A 68-year-old and an 80-year-old with the same Plan G would pay a similar rate.

That doesn't mean the premium never changes. It can — and usually does — rise over time because of inflation and rising medical claims. But your age alone isn't the trigger.

Method 2: Issue-age-rated

An issue-age-rated policy bases your premium on the age you were when you first bought the plan. If you buy at 65, your rate is tied to that starting age. Someone who buys the same plan at 72 will generally start out paying more.

Here's the key: your premium doesn't go up simply because you had a birthday. It can still rise due to inflation or claims trends across all policyholders — just not because you got older.

Method 3: Attained-age-rated

This is the method that catches people off guard. An attained-age-rated policy starts out lower at younger ages, but the premium is designed to increase as you age. So the price you see at 65 is not the price you'll pay at 75 or 85 — even before you factor in inflation.

Attained-age policies can look like the best deal at first glance. They may also become the most expensive later, when many retirees are on a fixed income and less likely to switch (since medical underwriting may apply outside your open enrollment window).

Why premiums rise even though benefits can't

Federal rules lock in the benefits of each standardized Medigap plan. What they don't lock in is the price. Insurers can raise premiums for reasons that apply to everyone in the plan, including:

• Higher medical and hospital costs (general inflation).
• The insurer's overall claims experience — how much the group is using care.
• Your age, if the policy is attained-age-rated.

Rate changes must be filed with and reviewed by state insurance regulators, but reviews vary from state to state.

What Goodyear residents should ask before signing

Goodyear is in Maricopa County, and the Medigap options available to you depend on which insurers sell in Arizona and how they've chosen to price their plans. Not every method is offered by every carrier, and availability differs by state.

Before you enroll, ask the agent or insurer directly:

• Is this policy community-rated, issue-age-rated, or attained-age-rated?
• What has the rate history looked like over the past several years?
• Will my premium increase automatically as I get older?

Your best protection is your Medigap Open Enrollment Period — the six months that begin the month you're 65 or older and enrolled in Part B. During that window, insurers cannot deny you coverage or charge more based on health. Outside it, switching plans later may require medical underwriting.

A quick note on the rest of Medicare in 2026

While you're comparing Medigap options, keep the broader 2026 picture in mind. Part D now has a $2,100 annual out-of-pocket cap on covered drugs, the maximum Part D deductible is $615, and the old coverage gap ("donut hole") is gone. The Medicare Prescription Payment Plan lets you spread drug costs across the year. IRMAA income surcharges begin above $109,000 for single filers. And the Annual Enrollment Period runs October 15 – December 7.