Medicare Supplement
Same Medigap plan, three price tags: how Westerly buyers should read the fine print
WESTERLY, R.I. — If you are shopping for a Medicare Supplement policy in Washington County, here is a truth that trips up a lot of first-time buyers: two neighbors can hold the very same lettered Medigap plan and pay very different premiums. And even though the federal government locks in what a Medigap plan covers, it does not lock in what you pay for it.
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Key takeaways
- Medigap benefits for each lettered plan (like Plan G or Plan N) are standardized by federal rule, but the premium is set by the insurer and can change over time.
- Insurers use one of three pricing methods: community-rated, issue-age-rated, or attained-age-rated.
- Which methods are offered depends on the insurer and the state, so two policies with identical benefits can be priced very differently.
- Premiums can rise due to inflation, claims experience across the insurer's pool, and — with attained-age policies — your age.
That is because Medigap policies are priced one of three ways — and the method your insurer uses shapes how your premium behaves for the rest of your life.
Benefits are standardized. Prices are not.
Medigap plans sold today are labeled with letters — Plan A, B, D, G, K, L, M and N, plus high-deductible versions of G and F for people who qualify. Under CMS rules, every insurer that sells a given letter has to offer the same core benefits for that letter. A Plan G is a Plan G, no matter whose name is on the envelope.
What is not standardized is the price. Each insurer files its own rates, and those rates depend on the pricing method the company uses in your state.
The three pricing methods
Community-rated (also called "no-age-rated"). Everyone who buys the same policy from the same insurer pays roughly the same premium, regardless of age. A 65-year-old and an 80-year-old on the same Plan G pay about the same base rate. Your premium will not go up simply because you had another birthday, but it can still rise for other reasons.
Issue-age-rated (also called "entry-age-rated"). Your premium is based on the age you were when you first bought the policy. Buy in at 65 and your rate is tied to that starting age. Buy in at 72 and you will generally start at a higher rate than the 65-year-old buyer. Your premium does not increase just because you get older after that.
Attained-age-rated. Your premium is based on your current age and goes up as you age. It usually starts lower than an issue-age or community-rated policy at 65, but it climbs in steps as you reach older age brackets.
Which of these methods you will actually be offered depends on the insurer and the state you live in. Some states require one method; others allow more than one. If you are shopping in Rhode Island, ask the insurer or your agent to tell you, in writing, which method applies to the specific policy you are considering.
Why the premium can rise even though the benefits can't
Even a community-rated policy can — and usually does — see rate changes over time. Three forces are at work:
- Inflation and rising medical costs. As doctors, hospitals and other providers charge more, the insurer pays out more on claims and files for higher rates.
- Claims experience. Insurers look at how much the whole pool of policyholders is costing them. If claims run higher than expected, rates can be adjusted for everyone in that pool.
- Your age, but only if you have an attained-age policy. That is the one method where getting older, by itself, moves your premium up.
None of these changes touch what the policy covers. Your Plan G will still pay what a Plan G pays. It is only the bill for the coverage that shifts.
What to look at before you sign
Two policies with identical letters can behave very differently over 10 or 20 years. When you compare Medigap options in Westerly, ask each insurer:
- Which pricing method does this policy use in Rhode Island?
- What has your rate history looked like for this policy over the last several years?
- Are there discounts (for example, household or non-tobacco) and do they continue in future years?
Also remember that your strongest consumer protection is the six-month Medigap Open Enrollment Period that starts when you are 65 or older and enrolled in Part B. During that window, insurers cannot deny you a policy or charge you more for health reasons. Outside of it, medical underwriting may apply.
Where to get unbiased help
Rhode Island's State Health Insurance Assistance Program (SHIP), known locally as SHIP-RI, offers free one-on-one counseling and can walk Westerly residents through Medigap options with no sales pressure. You can also compare plans and pricing methods offered in your ZIP code at medicare.gov, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Washington County
(MA penetration in Washington County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
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The parts of Medicare
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When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Does the federal government set Medigap premiums?
Which pricing method is "best"?
Can my insurer raise my Medigap premium just because I got older?
Do these pricing rules apply to Medicare Advantage plans too?
- CMS — Medicare Supplement Insurance (Medigap) rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Westerly
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This page was last updated: September 2026.