Medigap premiums typically range from about $50 to over $300 per month, depending on the plan letter you choose, where you live, your age, and the insurance company selling the policy. That’s a wide range because Medigap isn’t a single product. It’s a set of standardized plan types (labeled A through N) sold by private insurers who each set their own prices for identical coverage. Two companies in the same city can charge very different amounts for the same Plan G, so understanding what drives pricing is the key to controlling your costs.
What Drives the Price Differences
The plan letter is the biggest factor. Plans that cover more of your out-of-pocket Medicare costs carry higher premiums. Plan G and Plan F (no longer available to people who became eligible for Medicare after January 1, 2020) are the most comprehensive, covering nearly all gaps in Original Medicare. Plan N costs less per month but leaves you responsible for small copays at some office visits and, potentially, Part B excess charges. Plan K and Plan L split costs with you at set percentages, so their premiums are lower but your out-of-pocket spending is higher when you use care.
Geography matters almost as much as the plan letter. Premiums in metropolitan areas with higher healthcare costs can be double what you’d pay in a rural area of another state. Even within the same state, prices vary by county or zip code.
Three Pricing Methods That Shape Long-Term Costs
Every Medigap insurer uses one of three rating methods to calculate your premium, and the method determines how your costs change over time. Nationally, about 69 percent of available Medigap plans use the most common (and often least favorable) method, so it’s worth understanding all three before you buy.
Community-Rated Plans
Everyone enrolled in the same plan pays the same premium regardless of age. A 65-year-old and an 80-year-old are charged the same amount. Premiums can still rise with general inflation or healthcare cost increases, but your age never triggers a price hike. Only about 12 percent of Medigap plans use this method, and starting premiums tend to be higher than other options because the insurer isn’t discounting for younger, healthier enrollees.
Issue-Age-Rated Plans
Your premium is based on how old you were when you first enrolled. If you buy in at 65, you lock in the rate for that age group permanently. The premium can still increase due to inflation, but turning 70 or 75 won’t bump you into a more expensive bracket. About 19 percent of plans use this approach, and it tends to reward people who enroll early and stay put.
Attained-Age-Rated Plans
Your premium is recalculated based on your current age. These plans often look like a bargain at 65, with some of the lowest starting premiums on the market. But costs climb as you get older, and by your late 70s or 80s, you could be paying significantly more than someone on a community-rated or issue-age plan. This is the most common pricing method, covering roughly 69 percent of available plans. If you see a suspiciously low quote, check whether it’s attained-age before assuming you’ve found a deal.
How Premiums Increase Over Time
No matter which rating method your plan uses, premiums rise over time due to healthcare inflation. A Department of Health and Human Services analysis found that between 2001 and 2010, the average annual increase in Medigap premiums was 3.8 percent. That means a $150 monthly premium could grow to roughly $220 within a decade, even without any age-based increases layered on top.
Most increases are modest and predictable, but outliers exist. About 10 percent of Medigap policies during one studied period had average annual premium jumps exceeding 20 percent. These extreme spikes tend to happen with smaller insurers or plans with shrinking enrollment pools, where the remaining members are older and sicker, driving costs up for everyone left. Choosing a well-established insurer with a large membership base helps reduce the risk of surprise rate hikes.
The High-Deductible Option
If you’re comfortable absorbing some costs before your plan kicks in, the high-deductible version of Plan G can cut your monthly premium dramatically. For 2025, the annual deductible is $2,870. You pay all Medicare cost-sharing out of pocket until you hit that amount, then the plan covers everything just like a standard Plan G. Monthly premiums for high-deductible Plan G often run between $30 and $70, making this a popular choice for people who rarely need medical care and want to minimize their fixed monthly costs while still having a safety net for expensive events.
Why Enrollment Timing Affects Price
Your best pricing opportunity comes during your Medigap Open Enrollment Period: the six-month window that starts the first day of the month you turn 65 and are enrolled in Medicare Part B. During this window, insurers must sell you any Medigap plan they offer at the standard price, regardless of your health history. They can’t charge you more for pre-existing conditions or turn you down.
Once that window closes, the landscape changes. There’s no federal guarantee that a company will sell you a policy at all. If you can buy one, the insurer can use medical underwriting to assess your health, and past or current conditions can result in a higher premium or a flat-out denial. People who delay enrollment or try to switch plans years later often face prices 20 to 40 percent higher than what they would have paid at 65, assuming they can find coverage.
Potential Out-of-Pocket Costs Beyond the Premium
Your monthly premium isn’t always your only Medigap expense. Plan N, for example, doesn’t cover Part B excess charges. These happen when a doctor who doesn’t accept Medicare’s standard payment (called “accepting assignment”) bills you above the Medicare-approved amount. Medicare limits these extra charges to 15 percent of the approved amount. If you see specialists who don’t accept assignment, those charges add up. Plan G covers excess charges completely, which is one reason its higher premium can still be the better value for people who see many providers.
Plan N also has copays of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission. These are small amounts individually, but they’re worth factoring into your total annual cost comparison.
States With Special Switching Rules
Most states follow federal rules, meaning you have limited ability to change Medigap plans after your initial enrollment period without medical underwriting. But a handful of states have a “birthday rule” or “anniversary rule” that gives you a window each year to switch to a comparable or lesser plan from a different insurer, with no health questions asked. This lets you shop for lower premiums annually.
States with these protections include California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Missouri, Nevada, Oklahoma, Oregon, and Wyoming. Virginia’s birthday rule takes effect in July 2025. If you live in one of these states, you have more leverage to keep costs down over time by switching to a lower-priced insurer whenever your annual window opens.
How to Compare Actual Prices
Because Medigap plans are standardized by letter, a Plan G from one company covers exactly the same benefits as a Plan G from another. The only differences are price, customer service, and the insurer’s financial stability. That makes comparison shopping straightforward once you know which plan letter fits your needs.
Your state’s insurance department typically publishes a rate comparison guide listing every Medigap insurer operating in your area along with their current premiums by age and zip code. Medicare.gov also has a plan finder tool. When comparing quotes, confirm whether the price is community-rated, issue-age, or attained-age. A low starting premium on an attained-age plan can end up costing tens of thousands more over a 20-year retirement than a slightly higher community-rated premium that stays flat relative to age. Running the numbers over a 10 or 15 year horizon, not just the first year, gives you the most accurate picture of what Medigap will actually cost.