Medicare Supplement

Same Medigap Benefits, Rising Price? Here's Why

SPRINGFIELD, Mass. — If you've had a Medigap policy for a few years, you may have noticed something puzzling: the benefits on the page look identical to the day you signed up, but the premium keeps creeping higher. That's not a mistake, and it's not a bait-and-switch. It's a feature of how Medigap is priced.

Medigap policies — also called Medicare Supplement Insurance — are standardized by the federal government. A Plan G sold by one company covers the same gaps in Original Medicare as a Plan G sold by another. What isn't standardized is the price, and insurers are allowed to use one of three pricing methods. Understanding which method sits behind your policy is the key to understanding why your bill can change even when your coverage can't.

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

With community-rated pricing, everyone who holds the same policy pays roughly the same premium, no matter their age. A 68-year-old and an 82-year-old with the same Plan G from the same insurer would pay about the same base rate.

That doesn't mean the premium stays frozen. It can still go up over time because of inflation and rising medical costs. But your age alone won't push it higher.

Method 2: Issue-age-rated

Issue-age pricing locks in your rate based on the age you were when you first bought the policy. Buy in at 65, and your premium is calculated on a 65-year-old's rate. Buy in at 72, and it's calculated on a 72-year-old's rate.

Once you're in, the insurer can't raise your premium simply because you had another birthday. But — and this is the part people miss — the price can still rise due to inflation and the overall cost of claims across the pool of policyholders.

Method 3: Attained-age-rated

Attained-age pricing is the one that surprises people most. Your premium is based on your current age, so it goes up as you get older — often each year, or in age bands (say, every five years).

An attained-age policy may look attractive at 65 because the starting price is lower than issue-age or community-rated versions. But those premiums typically climb faster over time. On top of the age increases, inflation and claims trends can push the price higher too.

Why premiums rise even when benefits don't

Federal law standardizes Medigap benefits — a Plan G is a Plan G. What Congress didn't do was freeze the price. Insurers can raise premiums for reasons that have nothing to do with your individual coverage:

• Medical inflation. Hospital stays, tests, and outpatient care all get more expensive year over year, and Medigap pays a share of those bills.
• Claims experience. Insurers look at how much they've paid out for everyone in your pool. If claims run high, rates can be adjusted for the whole group.
• Your age, if you're in an attained-age policy.

State insurance departments generally have to approve rate increases, but approval doesn't mean no increase — it means the increase has been reviewed.

What this means in Springfield

Springfield is in Hampden County, and Medigap rules can vary by state. Massachusetts has its own standardized Medigap plan structure that works differently from most other states — another reason it's worth talking to a local counselor before you buy or switch.

A few practical steps:

• Ask any insurer or agent, in plain words: "Is this policy community-rated, issue-age-rated, or attained-age-rated?" Get the answer in writing.
• Ask about the insurer's rate-increase history over the last several years.
• Remember that once you're outside your Medigap Open Enrollment Period (the six months starting when you're 65 and enrolled in Part B), you may face medical underwriting if you try to switch policies later.

A quick note on the rest of Medicare

Medigap doesn't cover prescription drugs — that's Part D. For 2026, Part D has a $2,100 annual out-of-pocket cap, a maximum deductible of $615, and the old coverage gap ("donut hole") is gone as of 2025. The optional Medicare Prescription Payment Plan lets you spread drug costs across the year. IRMAA surcharges for higher-income enrollees start above $109,000 for a single filer in 2026.

Key dates to remember: Medicare's Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.