Medicare Supplement

Why Your Medigap Premium Can Rise Even When Benefits Don't

BRIGHTON, Colo. — If you've shopped for a Medicare Supplement Insurance plan — often called Medigap — you may have noticed that two people can buy the exact same plan and pay very different premiums. And even after you're enrolled, your premium can go up over time, even though the plan's benefits are set by law and cannot change.

The reason usually comes down to how the policy is priced. Medigap policies are typically sold using one of three pricing methods: community-rated, issue-age-rated, or attained-age-rated. Knowing which one you're being offered can help you make a more confident decision — especially in Brighton, where retirees often plan on a fixed budget for the long haul.

The three ways Medigap policies are priced

Medigap plans are standardized by the federal government. That means a Plan G from one company covers the same things as a Plan G from another company. What differs is the price — and how that price is built.

Here are the three pricing methods insurers use:

Community-rated (also called "no-age-rated"). Everyone who buys the policy from that insurer pays roughly the same monthly premium, no matter their age. A 65-year-old and an 80-year-old could pay a similar base rate.

Issue-age-rated (also called "entry-age-rated"). The premium is based on the age you were when you first bought the policy. If you bought it at 65, your rate is tied to that starting age. It won't go up simply because you had another birthday.

Attained-age-rated. The premium is based on your current age, and it goes up as you get older. These policies often start out cheaper at 65 but rise steadily as you age into your 70s and 80s.

Why premiums can rise even though benefits can't change

This is one of the most common points of confusion. The benefits inside a standardized Medigap plan are locked in by federal rules — an insurer can't quietly trim what Plan G covers. But the premium is a separate story.

Three things can push a Medigap premium higher over time:

• Inflation. Medical care costs generally rise year to year, and premiums often follow.
• Claims experience. Insurers look at how much they're paying out for the group of people enrolled in a given plan. If claims across that pool rise, rates can be adjusted.
• Your age. This only applies to attained-age-rated policies, where the rate is tied to how old you are right now.

Even a community-rated or issue-age-rated plan can see rate increases due to inflation or claims — they just won't jump specifically because you had a birthday.

How to think about which pricing method fits you

There isn't one "right" answer. It depends on your budget today, your expected budget years from now, and how long you plan to keep the policy.

An attained-age policy may look attractive at 65 because the starting premium can be lower. But you'll want to think about what the same policy might cost at 75 or 80. Community-rated and issue-age-rated policies tend to have more stable pricing as you age, though the starting premium may be higher.

A few questions worth asking any agent or insurer:

• Which pricing method does this policy use?
• How often has the company raised rates in the past few years?
• Are there other Medigap plans (like Plan G or Plan N) I should compare?

Which pricing methods are actually offered varies by insurer and by state, so it's worth checking what's available where you live before you assume you have all three choices.

What this means for Brighton residents

Brighton is in Adams County, where residents have access to Original Medicare plus optional Medigap and Part D coverage, along with Medicare Advantage as an alternative path. Medigap works alongside Original Medicare (Parts A and B) to help cover costs like coinsurance and deductibles.

If you're weighing Medigap options here, remember that the best time to buy is usually during your six-month Medigap Open Enrollment Period, which begins the month you're 65 or older and enrolled in Part B. During that window, insurers generally can't turn you down or charge more based on health history. Outside that window, protections vary.

For personalized help, Colorado's State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling.

A few other 2026 Medicare facts worth knowing

While you're reviewing coverage, keep these program-level 2026 figures in mind:

• The Part D out-of-pocket cap is $2,100.
• The Part D maximum deductible is $615.
• The old "donut hole" is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year.
• IRMAA surcharges start above $109,000 in income for a single filer.
• Annual Enrollment runs Oct. 15 – Dec. 7. Medicare Advantage Open Enrollment runs Jan. 1 – March 31.