Whether your Medigap premiums increase with age depends entirely on which pricing method your insurance company uses. Some Medigap policies raise your premium every year as you get older, while others lock in a rate based on your age at purchase and never adjust it for aging. Understanding which type you have, or which type to buy, can save you thousands of dollars over the course of your retirement.
The Three Medigap Pricing Methods
Every Medigap policy in the United States uses one of three pricing structures. Two of them will never raise your premium because of your age. The third will.
Attained-age-rated: Your premium is based on your current age and increases as you get older. A policy that costs $150 a month at age 65 will cost more at 70, more still at 75, and so on. This is the most common pricing method in most states, and it’s the one that catches people off guard. Premiums may start lower than other pricing types, but they climb steadily over time.
Issue-age-rated: Your premium is based on the age you were when you bought the policy. If you enrolled at 65, your rate reflects that age permanently. Your premium will not go up simply because you turned 66 or 76. The tradeoff is that your starting premium may be slightly higher than an attained-age plan’s introductory rate, but it stays more predictable over the long run.
Community-rated (also called no-age-rated): Everyone with the same plan pays the same premium regardless of age. A 65-year-old and an 80-year-old enrolled in the same policy pay the same amount. This offers the strongest protection against age-based price increases.
Premiums Still Rise for Other Reasons
Even with issue-age or community-rated plans, your premium is not permanently frozen at the dollar amount you first paid. Insurers can still raise rates for reasons that have nothing to do with your birthday. Inflation, rising healthcare costs, your geographic area, and smoking status can all push premiums higher over time.
Between 2001 and 2010, Medigap premiums rose an average of 3.8% per year, according to a U.S. Department of Health and Human Services analysis. That was actually slower than the 5.4% annual growth in overall Medicare spending per beneficiary during the same period. Medicare spending trends within each state turned out to be one of the strongest predictors of how much Medigap premiums climbed. So where you live matters: states with faster-growing healthcare costs tend to see steeper Medigap increases.
The key distinction is that these inflation-driven increases hit everyone, regardless of pricing method. With an attained-age plan, you’re paying those general increases on top of age-based increases, which is why costs can accelerate noticeably in your 70s and 80s.
Which Pricing Method Costs Less Over Time
Attained-age plans often advertise the lowest starting premiums, which makes them appealing at 65. But the math changes over a 20- or 25-year retirement. Someone on an attained-age plan who starts at a lower monthly cost may end up paying significantly more in total by their late 70s or early 80s compared to someone who locked in a higher issue-age rate at 65.
Issue-age and community-rated plans front-load the cost slightly. You pay a bit more in the early years, but you avoid the compounding effect of annual age-based hikes layered on top of inflation adjustments. If you expect to keep your Medigap coverage for a long time, the cumulative savings from avoiding age-based increases can be substantial. If you’re enrolling later in life, say at 72 or 75, the calculus shifts because there are fewer years for the attained-age increases to compound.
Eight States Ban Age-Based Pricing
Eight states require all Medigap policies to use community rating for policyholders age 65 and older: Arkansas, Connecticut, Massachusetts, Maine, Minnesota, New York, Vermont, and Washington. In these states, insurers cannot use issue-age or attained-age pricing at all. If you live in one of them, your premiums will never increase because of your age.
This is a significant consumer protection. In the remaining 42 states, insurers choose which pricing method to use, and many default to attained-age rating. You’ll need to check with your specific insurer or your state insurance department to confirm which method applies to a given policy. The pricing method should be disclosed in the policy documents, but it’s worth asking directly before you sign up, because it’s one of the most important variables in your long-term costs.
Why Enrollment Timing Matters
Your six-month Medigap Open Enrollment Period starts the first month you are both 65 or older and enrolled in Medicare Part B. During this window, insurers cannot charge you more or deny you coverage based on your health status, claims history, or medical conditions. Federal law prohibits it.
This matters for pricing in a practical way. Outside of this window, insurers in most states can use medical underwriting, which means they can factor in pre-existing conditions and charge higher premiums or decline your application entirely. If you’re buying an issue-age or community-rated plan, enrolling during this period locks you in at the lowest possible rate for your age without any health-related surcharges.
Some states offer additional protections beyond the federal rules. A few states have “birthday rule” provisions that let you switch Medigap plans around your birthday each year without medical underwriting, giving you a chance to shop for better rates even after your initial enrollment window closes. Contact your state insurance department to find out what options are available where you live.
Choosing the Right Pricing Structure
If you’re comparing Medigap policies, don’t just compare the monthly premium you’ll pay today. Ask each insurer which pricing method they use and get it in writing. An attained-age plan that looks $30 cheaper per month at age 65 could cost $100 more per month than an issue-age plan by the time you’re 80.
For people enrolling at 65 who plan to keep their coverage long-term, issue-age or community-rated plans generally offer more predictable costs. For someone enrolling later in life who may only need coverage for a shorter period, the lower starting cost of an attained-age plan might make more financial sense. Either way, budget for annual increases in the range of 3% to 5% from inflation and rising healthcare costs, because those affect every Medigap policy regardless of how it’s priced.