Medicare Supplement

Three Ways Medigap Is Priced — And Why Your Bill Can Climb

# Attained-age, issue-age, community-rated: what your Medigap price is built…

KENOSHA, Wis. — If you've shopped for a Medicare Supplement (Medigap) policy, you've probably noticed something strange. Two people can buy the exact same lettered plan — say, Plan G — from two different insurers and pay very different premiums. And a few years later, one of them may see their bill go up faster than the other, even though the benefits haven't changed at all.

That's not a mistake. It comes down to how the insurer prices the policy. Medigap plans are standardized by the federal government, so the benefits inside Plan G (or Plan N, or Plan K) are the same no matter who sells them. But the price is set by the insurance company using one of three pricing methods: community-rated, issue-age-rated, or attained-age-rated. Which one applies to you depends on the insurer and the state you live in.

Here's how each one works, and why your premium can still rise over time.

Community-rated (also called "no-age-rated")

With a community-rated policy, everyone who has the same Medigap plan from that insurer pays roughly the same premium, regardless of age. A 68-year-old and an 82-year-old with the same Plan G would pay the same base rate.

Your premium won't rise just because you had a birthday. But it can still go up over time because of inflation and the insurer's overall claims experience — meaning how much the company is paying out for the people it covers.

Issue-age-rated

An issue-age-rated policy locks in your premium based on the age you were when you first bought the plan. Someone who buys at 65 will generally pay less than someone who buys the same plan at 72, and that "starting point" sticks with you.

Like community-rated policies, issue-age premiums don't climb simply because you get older. They can still rise, though, due to inflation and claims costs across the insurer's pool of customers.

Attained-age-rated

This is the method that surprises people the most. With attained-age pricing, your premium is based on your current age and typically increases as you get older. It may look cheap at 65 and cost noticeably more at 75 or 85, on top of any inflation-driven increases.

None of that means the plan changed. The benefits inside a Medigap letter are federally standardized and can't be trimmed by the insurer. It's the pricing formula that's moving.

Why premiums can rise on any of the three

No matter which method an insurer uses, a Medigap premium is not frozen for life. Insurers can raise rates over time for reasons that include:

• General inflation in health care costs.
• Claims experience — if the insurer is paying out more for the group of people in that plan, rates can go up.
• Age — but only if you're in an attained-age-rated policy.

State insurance departments regulate how and when insurers can raise these rates. Which pricing methods are even allowed can vary by state, so what a neighbor in another state pays or experiences may not match your situation in Wisconsin.

What this means if you live in Kenosha

Kenosha is in Kenosha County, and Medigap rules in Wisconsin have some unique features — Wisconsin is one of three states (along with Massachusetts and Minnesota) that standardize Medigap differently from the rest of the country. That makes it especially important to ask an insurer two questions before you sign anything:

1. Which pricing method does this policy use? 2. How have premiums for this plan changed over the last several years?

You have the strongest protections when you first become eligible. During your six-month Medigap Open Enrollment Period — which starts the month you're 65 or older and enrolled in Part B — insurers generally can't turn you down or charge you more because of health conditions. Outside that window, medical underwriting may apply.

How Medigap fits with the rest of Medicare in 2026

Medigap only works alongside Original Medicare (Parts A and B). It doesn't cover prescription drugs — for that, you'd add a stand-alone Part D plan. A few 2026 numbers worth knowing:

• Part D has an annual out-of-pocket cap of $2,100.
• The Part D maximum deductible is $615.
• The old "donut hole" coverage gap was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
• IRMAA surcharges on Part B and Part D premiums start above $109,000 in income for a single filer in 2026.
• The Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31. Medigap has its own enrollment rules and is not tied to these windows.