Here is a fact that surprises many Medigap shoppers: two insurance companies can sell the exact same plan letter — identical benefits, guaranteed by federal standardization — at very different prices. And the sticker price at 65 does not tell the whole story, because carriers use one of three rating methods to set premiums, and those methods behave very differently as you age. A policy that looks like the lower-cost option today may not be at 80. Here is how each method works and which states restrict them.
The Short Answer
Federal rules standardize Medigap benefits, not premiums. Every Plan G covers the same things, but what you pay depends on the carrier and on how the policy is rated:
- Community-rated — everyone with the same policy pays the same premium, regardless of age
- Issue-age-rated — your premium is based on your age when you buy, and your own aging does not raise it later
- Attained-age-rated — your premium is based on your current age and generally rises as you get older; this is the most common method nationally
One point deserves emphasis: no rating method freezes your premium. All three still see increases from inflation, rising medical costs, and the claims experience of the whole insured pool. The rating method controls one variable only — whether your own aging raises your rate. If you are still getting oriented on what Medigap is, start with our full guide to Medicare Supplement insurance.
Community-Rated (No-Age-Rated) Pricing
With community rating, everyone with the same policy pays the same premium, regardless of age. A 65-year-old and an 82-year-old buying the identical plan from the same carrier generally pay the same amount.
The trade-off is timing. Community-rated premiums may look higher than attained-age premiums at 65, because younger buyers are effectively sharing costs with older members of the pool. But because your own birthday never triggers an increase, the premium may compare more favorably as the years pass. Premiums can still rise for everyone at once — inflation and pool-wide claims experience see to that.
Issue-Age-Rated Pricing
With issue-age rating, your premium is based on your age on the day you buy the policy, and you stay in that age class permanently. Buy at 65 and you keep the 65-year-old pricing structure for life; someone who first buys at 72 starts — and stays — at a higher tier.
Issue-age premiums typically start somewhat higher than attained-age premiums at 65, but they do not climb simply because you age, so this method generally rewards buying earlier. The carrier can still raise rates for the entire class due to medical cost trends.
Attained-Age-Rated Pricing
With attained-age rating, your premium is based on your current age — and it is recalculated upward as you get older. These policies generally carry the lowest prices at 65, which makes them attractive to new shoppers.
The catch is the trajectory: on top of inflation-driven increases, attained-age policies add age-based increases, so the gap versus community-rated or issue-age policies may narrow or reverse by your late 70s or 80s. Attained-age is the most common rating method nationally, so if a quote does not say otherwise, it is worth asking.
For the underlying value question — premium paid versus cost-sharing avoided — see our guide to whether Medigap is worth the cost.
State Rules That Restrict Rating Methods
Rating methods are regulated at the state level, and some states limit which methods carriers may use:
- Nine states require community rating: Arkansas, Connecticut, Idaho, Massachusetts, Maine, Minnesota, New York, Vermont, and Washington
- Four states allow issue-age but ban attained-age rating: Arizona, Florida, Georgia, and Missouri
If you live in one of these states, every quote you see will already follow its rules. And if you relocate, your new state's rules can change your options — our guide to Medicare when you move to a new state covers what to check.
Birthday Rules and Other State Switching Windows
Because switching Medigap policies later generally involves medical underwriting, the choice you make at 65 can feel locked in. But a growing list of states has created annual windows to switch without health questions:
- Birthday rules give you a yearly window around your birthday to switch to a policy with equal or lesser benefits without underwriting. As of 2026, 16 states have some version, including California (60 days from the first day of your birth month), Oregon (30 days before to 30 days after your birthday), Idaho, Illinois (ages 65–75, same carrier), Indiana and Delaware (new for 2026), Virginia (since July 2025), Wyoming, Oklahoma, Kentucky, Louisiana, Maryland, Nevada, Utah, and West Virginia (effective June 11, 2026) — plus Missouri's rule, tied to your policy anniversary rather than your birthday.
- Connecticut and New York offer year-round guaranteed issue; Massachusetts holds an annual open enrollment window; Maine guarantees switching to plans with equal or lesser benefits.
The details — eligibility ages, window lengths, which plans qualify — vary significantly by state, so confirm your state's rule with your state insurance department or SHIP before counting on it. Outside these windows, federal protections still apply in specific situations; see our guide to guaranteed issue rights.
Questions to Ask Before You Buy
A few minutes of questions can prevent decades of surprises:
- "How is this policy rated?" The carrier must disclose this in the outline of coverage you receive before buying.
- "Can you show me current premiums at ages 70, 75, and 80?" This reveals the trajectory, not just the starting point.
- "What has the rate-increase history looked like?" Past increases are not a guarantee, but they are informative.
- "Does my state have a birthday rule or other switching window?" This affects how locked in your choice really is.
How to Get Help and Learn More
These official resources can help you compare rating methods and pricing in your area:
- Medicare.gov — Learn how Medigap costs are set and compare policies at medicare.gov/health-drug-plans/medigap/basics/costs.
- 1-800-MEDICARE (1-800-633-4227) — Medicare's official helpline can answer Medigap pricing questions. TTY users can call 1-877-486-2048.
- State Health Insurance Assistance Program (SHIP) — SHIP offers free, unbiased counseling and can explain your state's rating rules and switching windows. Find your local program at shiphelp.org or by calling 1-800-MEDICARE.
Summary and Next Steps
How a Medigap policy is priced can matter as much as what it costs today. Key points to remember:
- Federal standardization covers benefits, not premiums — identical plan letters can carry very different prices
- Community-rated: same premium for all ages; issue-age: locked to your purchase age; attained-age: rises as you age and is the most common method nationally
- All three methods still see increases from inflation, medical cost trends, and pool-wide claims — the rating method only controls whether your own aging raises your rate
- Nine states require community rating; four more ban attained-age rating
- 16 states now have birthday rules or similar annual switching windows, with details that vary significantly by state
- The outline of coverage discloses the rating method — ask before you buy
Before you commit, ask the carrier how the policy is rated and request sample premiums at older ages. And if you want help decoding the answers, your local SHIP counselor can compare the options with you for free.
