Category: Costs

The Hard Truth About Medigap and Financial Help

Most people who ask me about financial help for Medigap premiums have already spent an hour on Medicare.gov and come away more confused than when they started. So let me be direct: there is no federal program that pays your Medigap premium the way Medicaid pays your Part B premium. That gap in the system is real, and it frustrates me too. But there are legitimate ways to reduce what you’re paying, and some of them are significantly underused.

Here’s the thing. The help that exists is scattered across state programs, low-income subsidy rules, insurer practices, and one underrated enrollment strategy that almost nobody talks about. None of it is a silver bullet, but together these options can meaningfully reduce what you’re spending on a supplement plan every month. I’ve seen people cut their Medigap costs by $80 or more per month just by knowing where to look.

Before I walk you through the options, one critical framing point: Medigap and Medicaid are not the same thing. If you qualify for full Medicaid, you likely don’t need Medigap at all. Medicaid covers most of the cost-sharing that Medigap would otherwise handle. So the people this article is really written for are the ones in the middle: too much income for Medicaid, not enough income to feel comfortable paying $150 a month for a supplement plan. That’s a frustrating place to be, and it’s exactly where targeted help is hardest to find.

State Pharmaceutical and Insurance Assistance Programs (SHIPs and SPAPs)

Every state has a State Health Insurance Assistance Program, known as SHIP. These are free counseling programs staffed by trained volunteers who help Medicare beneficiaries understand their options. They don’t pay your premiums directly, but that’s not why you should care about them. SHIP counselors often know about state-specific programs that you’d never find on your own.

Some states have gone further than others. New York, for example, has state rules that dramatically affect how Medigap is priced. Connecticut has community rating laws that prevent insurers from charging more based on your age, which indirectly makes premiums more affordable over time. If you’re in a state with favorable Medigap regulations, a SHIP counselor can explain exactly how those rules benefit you.

State Pharmaceutical Assistance Programs, or SPAPs, are a separate beast. These programs were originally built to help low-income seniors afford prescription drug costs, but some states have expanded them or have companion programs that help with other Medicare costs including, in some cases, Medigap premiums. Connecticut’s ConnPACE, for instance, has helped supplement costs for qualifying residents. Indiana and New Jersey have had similar programs at various points. These programs change frequently, which is exactly why talking to your SHIP counselor is so useful. They track the changes so you don’t have to.

To find your state’s SHIP, go to shiphelp.org. The service is free and there’s no catch. In my experience, the people who benefit most from SHIP counseling are those who assume they’ve already found all their options online. They usually haven’t.

Medicare Savings Programs: The Underused On-Ramp

This is where I see the biggest knowledge gap, and it matters for Medigap indirectly in a way that’s not obvious at first.

Medicare Savings Programs (MSPs) are federal and state programs that help pay Medicare cost-sharing for people with limited income and assets. There are four levels, but the one most relevant here is the Qualified Medicare Beneficiary (QMB) program. QMB pays your Part A and Part B premiums, deductibles, and coinsurance. If you qualify, you’re essentially getting what Medigap covers for free through government assistance.

Here’s the thing a lot of people miss: if you qualify for QMB, you may not need Medigap at all. I’ve talked to people paying $130 a month for a Plan G supplement when they would have qualified for QMB and paid almost nothing. That’s money they didn’t have to spend.

The 2026 income limits for MSPs vary by state, but roughly speaking, QMB eligibility starts around $1,255 per month for an individual ($1,704 for a couple). Some states have higher limits. Asset limits have been loosened in many states over the past several years, so even if you were turned down before, it’s worth reapplying.

The programs work like a ladder:

• QMB (Qualified Medicare Beneficiary): Covers Part A and B premiums, deductibles, and coinsurance
• SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premium only
• QI (Qualifying Individual): Also covers Part B premium, slightly higher income limit
• QDWI (Qualified Disabled and Working Individuals): Covers Part A premiums for working disabled people

If you’re on the boundary of QMB eligibility and you’re paying for Medigap, you need to run the numbers. Your state Medicaid office processes these applications, and SHIP can help you figure out where you stand before you apply.

The Guaranteed Issue Strategy Most People Don’t Use

This one isn’t about finding a subsidy. It’s about using enrollment timing to avoid overpaying for coverage you shouldn’t need to pay top dollar for in the first place.

Most people know there’s a six-month Medigap open enrollment window that starts when you turn 65 and enroll in Part B. During that window, insurers can’t deny you coverage or charge you more for pre-existing conditions. After it closes, you’re generally subject to medical underwriting, which can raise your premium significantly or get you denied outright.

What fewer people know is that there are other guaranteed issue rights built into federal law. If you lose employer coverage, if your Medicare Advantage plan leaves your area, or if certain other “triggering events” occur, you get a limited window to enroll in Medigap without underwriting. These windows are strict. They’re usually 63 days. And they apply to specific plan types, not all of them.

Why does this matter for people with limited incomes? Because if you’re 68 and on a Medicare Advantage plan partly because the premiums seemed lower, and that plan starts causing problems with provider access or prior authorizations, you may want to switch to original Medicare plus a Medigap supplement. Using the guaranteed issue right properly means you don’t pay a health-rated premium. A 68-year-old in Ohio with a pre-existing condition could be looking at the difference between $155 and $220 a month just based on whether or not they trigger and use that right correctly.

I’d strongly recommend talking to a broker or SHIP counselor before you make any moves here. Timing is everything, and one misstep can cost you the window.

The Common Mistake: Assuming Medigap Is Always the Right Solution

I have to say this plainly because I’ve watched it cost people money for years. A lot of people in tight financial situations are sold on Medigap because it feels like security. And it is, for the right person. But for someone with a genuinely low income and low healthcare utilization, paying $150 to $180 a month for a Plan G supplement might not make mathematical sense.

Let’s look at what Plan G actually covers relative to its cost in 2026:

What Plan G Covers	2026 Amount
Part A hospital deductible (per benefit period)	$1,676
Part B excess charges	Varies
Part B deductible	Not covered (that’s Plan F)
Part A coinsurance for extended hospital stay	Up to $838/day (days 61-90)
Skilled nursing facility coinsurance	Up to $209.50/day (days 21-100)

If you’re a reasonably healthy 67-year-old with maybe three doctor visits a year and no hospitalizations, you might pay $1,800 to $2,160 annually in Plan G premiums for protection you never trigger. For some people, a high-deductible Plan G at $40 to $60 a month makes far more sense. The deductible for high-deductible Plan G in 2026 is $2,870, but your monthly premium savings could offset much of that if you stay healthy.

The mistake isn’t buying Medigap. The mistake is buying standard Plan G by default when you haven’t run the numbers honestly for your actual health situation and budget.

Bottom Line

If your income is low enough to qualify for a Medicare Savings Program, start there before spending a dollar on Medigap. For everyone else who’s struggling with premiums, call your state SHIP office first. It’s free, they know your state’s specific options, and they’ll tell you if there’s a state assistance program you’re missing. If you’re already on a Medigap plan and paying more than you need to, high-deductible Plan G is the most underused cost-reduction tool available to relatively healthy beneficiaries.

Frequently Asked Questions

Is there a federal program that pays Medigap premiums directly?

No. There is no federal program specifically designed to pay Medigap premiums. The Medicare Savings Programs cover Part B and sometimes Part A premiums, which is different. If you qualify for QMB, you may not need Medigap at all, since QMB covers most of the same cost-sharing.

Can I get help with Medigap premiums if I’m just above Medicaid limits?

Possibly. Some states have programs for people in the “coverage gap” between Medicaid and comfortable affordability. SHIP counselors in your state are the best people to ask. The programs vary significantly, and they change regularly.

What’s the cheapest legitimate Medigap plan?

High-deductible Plan G is typically the lowest premium option that still gives you meaningful protection. In 2026, premiums can run $40 to $70 per month at age 65, depending on your state and insurer. You pay out of pocket until you hit the $2,870 annual deductible, and then the plan picks up. It’s a smart choice for healthy people who want catastrophic protection without high monthly costs.

If I can’t afford any Medigap plan, what should I do?

First, apply for a Medicare Savings Program through your state Medicaid office. If you don’t qualify, seriously consider a Medicare Advantage plan, which often has $0 or very low premiums. Advantage plans have their own trade-offs around networks and prior authorizations, but for someone truly unable to afford a supplement, they’re often the better financial call than going unprotected on original Medicare alone.

What You’re Actually Paying For (And What Most People Miss)

Most people shopping for a Medicare supplement plan focus entirely on the monthly premium and stop there. That’s a mistake I’ve seen cost people hundreds of dollars a year, sometimes more.

Here’s the thing: your true out-of-pocket cost with a Medigap plan has three parts. There’s the monthly premium you pay the insurance company, the cost-sharing that still falls on you under your specific plan, and the underlying Medicare deductibles that may or may not be covered depending on which plan you chose. Add all three together and you get a real number. Ignore any one of them and your estimate is garbage.

Let me walk you through how to actually do this calculation, so you’re comparing plans on equal footing and not getting surprised by a bill six months after you’ve enrolled.

Start With Medicare’s Built-In Cost Structure

Before you can estimate your Medigap costs, you need to understand what Medicare itself charges. Original Medicare has two main deductibles that matter here.

The 2026 Part B deductible is $257. That’s the amount you pay out-of-pocket each year before Medicare starts covering your outpatient services, doctor visits, lab work, and similar care. After that deductible, Medicare pays 80% and you owe 20% with no cap, which is the entire reason Medigap exists.

The 2026 Part A deductible is $1,676 per benefit period. This one confuses people because it’s not annual — it resets each time you start a new hospital benefit period. If you get admitted to the hospital twice in a year and the stays are separated by more than 60 days, you could owe that deductible twice. For someone who stays generally healthy, this might never come up. For someone managing a chronic condition, it absolutely can.

Medicare also charges daily coinsurance for extended hospital stays. Days 61 through 90 cost you $419 per day in 2026. After 90 days, you’re burning through your 60 lifetime reserve days at $838 per day. These numbers are why a single serious hospitalization can wreck someone’s finances without a supplement plan covering them.

How Each Medigap Plan Changes Your Actual Exposure

Not all Medigap plans cover the same things, and this is where the real math happens. I’m going to focus on the plans most people actually buy, because there are technically 10 standardized plan types and most of them aren’t worth your time to analyze.

Plan	Part A Deductible	Part B Deductible	Part B 20% Coinsurance	Typical Monthly Premium (Age 65)
Plan G	Covered	You pay $257/year	Covered	$100-$200/month
Plan N	Covered	You pay $257/year	You pay up to $20/visit copay	$80-$140/month
Plan F	Covered	Covered	Covered	$130-$250/month

Plan F is only available to people who became Medicare-eligible before January 1, 2020. If you turned 65 after that date, it’s not an option for you.

Plan G is what I’d point most new Medicare enrollees toward. You pay the $257 Part B deductible once a year, and after that, virtually everything else is covered. Your maximum exposure is highly predictable. Plan N costs less per month but adds copays of up to $20 per doctor visit and up to $50 for emergency room visits that don’t result in inpatient admission. If you see doctors frequently, those copays add up fast and can erase the premium savings.

How to Build Your Actual Annual Cost Estimate

Here’s the formula I’d use. Take your monthly premium and multiply by 12. Add the deductibles your plan doesn’t cover. Then estimate your copays or remaining cost-sharing based on how often you realistically use medical care.

Let’s use a real example. Say you’re a 67-year-old in Ohio on Plan G, paying $145 per month in premiums. You see your primary care doctor four times a year, you had one specialist visit, and you stayed healthy otherwise.

• Annual premium: $145 x 12 = $1,740
• Part B deductible you owe: $257
• Remaining out-of-pocket after deductible: $0 (Plan G covers the 20%)
• Total annual cost: $1,997

Now run that same person on Plan N at $115 per month with five doctor visits.

• Annual premium: $115 x 12 = $1,380
• Part B deductible: $257
• Visit copays: 5 visits x $20 = $100
• Total annual cost: $1,737

Plan N saves $260 per year in this scenario. But if that same person sees specialists more often, or has a year with an unexpected illness that means 12 or 15 visits, the math flips. That’s not a scare tactic — it’s just the honest arithmetic. Plan N rewards light users. Plan G rewards predictability.

One thing to factor in that most people don’t: premium inflation. Medigap premiums increase every year, and they typically increase faster than Medicare’s deductibles. When you’re comparing Plan G to Plan N today, you’re also betting on which plan’s premiums will stay more manageable over the next 10 to 15 years. I’d rather lock into a slightly higher premium now on a plan with no surprises than chase savings on a plan where cost-sharing can grow unpredictably.

The Mistake That Costs People the Most Money

I’ve seen this happen over and over: someone picks a lower-premium plan thinking they’re saving money, then mentally stops tracking their actual spending. They assume they’re ahead. They’re often not.

The most common version of this mistake is choosing a high-deductible Plan G (HD-G) without understanding how the deductible works. In 2026, the HD-G deductible is $2,870. That means you pay the first $2,870 of Medicare-covered costs entirely out of pocket before the plan kicks in. The monthly premium is much lower, sometimes $30 to $60 per month, which looks spectacular on paper.

The math only works in your favor if you stay genuinely healthy year after year. And here’s what people don’t think about: you’re choosing this plan at 65 or 67, but you’re going to be on it at 75 or 80 too. The odds that you’ll stay under that $2,870 threshold get worse over time, not better. I’ve talked to people who picked HD-G at 65, had a moderately rough year at 72, and paid the full deductible plus their premiums and came out worse than they would have on standard Plan G.

That doesn’t mean HD-G is never the right call. If you’re exceptionally healthy, have significant savings you can use to cover a bad year, and are disciplined about running the numbers annually, it can work. But it’s not a plan I’d recommend casually to someone who just wants predictable costs.

When Your Health History Should Change the Math

If you’re estimating future costs, you can’t just look at what you spent last year. You need to think about where you’re headed.

Someone with well-managed Type 2 diabetes, for example, probably sees their primary doctor four times a year, an endocrinologist twice, and maybe an ophthalmologist once annually. That’s seven visits right there, plus labs. Under Plan N, seven visits at $20 each adds $140 in copays annually. Under Plan G, that’s $0 in copays. The premium gap between the two plans needs to be wider than $140 per month before Plan N wins on pure math, and in most states, it isn’t.

People managing heart disease, COPD, or any condition that involves regular specialist care should almost always lean toward Plan G. The math is just cleaner, and the protection is more complete. Healthy people with no chronic conditions have a real argument for Plan N or HD-G, but they need to run the numbers honestly and revisit them every few years.

I’d also tell anyone approaching 70 to think hard before switching to a lower-premium option. In most states, once you’re past your initial enrollment window, switching plans requires medical underwriting. If your health has changed, you might not qualify for a better plan later. The time to lock in good coverage is when you’re healthy enough to get it.

Bottom Line

For most people, Plan G gives you the most predictable total out-of-pocket cost, and predictability is worth something when you’re on a fixed income and can’t afford surprises. Run the full annual math — premiums plus all remaining cost-sharing — not just the monthly premium, and you’ll usually find that Plan G’s advantage is bigger than the sticker price suggests. If you’re in excellent health and can comfortably absorb a bad year financially, Plan N is worth a real look, but go in with eyes open and a calculator in hand.

Frequently Asked Questions

Does Medicare supplement cover prescription drugs?

No. Medigap plans don’t cover prescription drugs at all. You need a separate Part D plan for that, and your drug costs are entirely separate from the out-of-pocket estimate we’re talking about here. Factor your Part D premium and expected drug costs into your total Medicare budget as a separate line item.

Can my Medigap premium increase every year?

Yes, and it will. Medigap premiums increase annually, typically between 3% and 8% per year depending on your insurer, your state, and how your plan is priced. This is one reason I’d rather see someone start on a slightly lower-premium plan with a strong carrier than chase the lowest possible premium with a company that has a history of aggressive rate increases.

What if I only go to the doctor once or twice a year — is Medigap even worth it?

Probably yes, but the math is closer. Light medical users sometimes do fine with Medicare Advantage instead of Medigap. But Medigap’s value isn’t just about what you spent last year — it’s about protection against the year you get a serious diagnosis, need surgery, or spend time in the hospital. One hospital stay without a Medigap plan can cost you thousands. One hospital stay with Plan G costs you essentially nothing beyond your annual deductible.

Are Medigap costs the same no matter which insurance company I choose?

The coverage is standardized by law, meaning a Plan G from one company covers exactly the same things as a Plan G from another. But the premiums vary significantly between insurers for the exact same plan. Shopping multiple carriers in your state for the same plan type is one of the easiest ways to save money without giving up any coverage. In some states, the price difference for the same plan can be $50 or more per month.

The Real Difference Between High and Low Deductible Medigap

Most people picking a Medigap plan get this wrong: they focus on the monthly premium and stop there. That’s a mistake that can cost you thousands of dollars over a few years, sometimes in the wrong direction.

Here’s the basic setup. A standard Plan G (the most popular Medigap plan in 2026) covers nearly everything Medicare doesn’t, starting from dollar one after you’ve paid the 2026 Part B deductible of $257. You pay a monthly premium, typically somewhere between $100 and $200 at age 65 depending on your state and insurer, and in exchange you get predictable costs. A bad health year doesn’t wreck your budget.

High Deductible Plan G works differently. The premium drops significantly, often to $40-$70 per month at age 65. But before the plan kicks in and starts covering your out-of-pocket costs, you have to meet a deductible. In 2026, that deductible is $2,870. Until you hit that threshold, you’re paying for Medicare cost-sharing yourself.

So you’re essentially choosing between paying more every month for certainty, or paying less every month and absorbing costs if you get sick. Neither choice is automatically right. But for most healthy retirees who are disciplined savers, I’ll tell you upfront: high deductible is underused and underappreciated.

How the Numbers Actually Play Out Year to Year

Let’s put real math on this. Take a 67-year-old woman in Ohio. She’s comparing standard Plan G at $140/month versus High Deductible Plan G at $55/month. That’s a $85/month difference, or $1,020 per year in savings on premiums alone.

In a healthy year where she sees her primary care doctor three or four times and gets a couple of routine labs, her out-of-pocket Medicare cost-sharing might total $400 to $600. She never gets close to the $2,870 deductible. With the high deductible plan, she’s ahead by $400 to $600 that year after factoring in her lower premiums.

Now say she has a rough year. A hospital admission, some specialist visits, maybe a minor procedure. She hits the full $2,870 deductible. On standard Plan G, those same costs would’ve been covered from dollar one (after the Part B deductible). So on paper she’s “behind” by $2,870 minus her premium savings. In year one, that gap is real. But if she’s been banking $85 per month, she’s built a cushion that covers it within three years of premium savings.

This is the math that matters. Here’s a side-by-side for context:

Scenario	Standard Plan G (est. $140/mo)	High Deductible Plan G (est. $55/mo)
Annual premium cost	$1,680	$660
Healthy year out-of-pocket	$257 (Part B deductible)	$257 to $800
Bad year out-of-pocket	$257	Up to $2,870
Total cost, healthy year	$1,937	$917 to $1,460
Total cost, bad year	$1,937	$3,530

The standard plan’s total cost barely changes year to year. That’s the point of it. The high deductible plan saves you money in most years but hits harder in a bad year. Whether that tradeoff makes sense depends on your health, your savings, and your temperament.

Who Should Choose Each Option (And I Mean Specifically)

I’ve talked to a lot of people about this over the years, and the clearest way I can put it is this: high deductible plans are for people who are genuinely healthy and have a financial cushion. Standard plans are for people who want to sleep at night without thinking about medical bills.

High Deductible Plan G makes sense if you:

• Are in good health at enrollment with no major chronic conditions requiring frequent specialist care
• Have at least $5,000 to $10,000 in accessible savings you could tap in a bad year without panic
• Are comfortable with some year-to-year variability in your healthcare spending
• Plan to stay on this plan for several years, giving the cumulative premium savings time to build up
• Are budget-conscious and would rather have lower fixed monthly expenses

Standard Plan G (or Plan N if you want a middle-ground option) makes more sense if you:

• Have ongoing health issues that mean regular doctor visits, prescriptions that require monitoring, or any condition that lands you in the hospital periodically
• Are on a tight fixed income where a $2,870 unexpected bill would be genuinely disruptive
• Have significant anxiety about medical costs and want a plan that makes those predictable
• Are enrolling at 70 or older, when the odds of a bad health year are higher

One thing I want to say directly: if you’re 65 and healthy and your main concern is keeping your monthly expenses low during the early years of retirement, high deductible is often the smarter financial move. Most 65-year-olds don’t have a catastrophic health year right out of the gate.

The Mistake I See People Make All the Time

Here it is. People hear “high deductible” and immediately think it means low-quality coverage. It doesn’t. High Deductible Plan G covers exactly the same things as standard Plan G. The benefits are identical. The only difference is when they kick in.

I’ve seen people pay $150/month for standard Plan G for 10 years, spend maybe $300-$500 out of pocket most years, and never once hit anything close to the catastrophic costs they were afraid of. Over a decade, they paid $18,000 in premiums. Someone on High Deductible Plan G paying $60/month would have paid $7,200 in premiums over the same period. Even if that person had two genuinely bad years and hit the full deductible both times, they’d have spent $7,200 + $5,740 = $12,940. Still less.

The fear isn’t irrational. Nobody wants to be sick and broke. But the math over a 10-year window typically favors high deductible for healthy enrollees, and most people don’t run that math before deciding.

The other misconception worth addressing: some people think you can switch freely between plans later. You generally can’t without underwriting, at least not in most states. Once you’re past your open enrollment period, switching from standard to high deductible might require medical underwriting, and if your health has changed, you could be denied or charged more. This is exactly why the decision you make at 65 matters so much.

A Few Things That Tip the Scales

Your state matters more than people realize. Some states, like Massachusetts, Minnesota, and Wisconsin, have standardized Medigap differently, so the high/low deductible comparison works differently there. If you’re in one of those states, get state-specific guidance before assuming what I’ve described here applies to you.

Your age at enrollment also shifts the calculation. A 65-year-old choosing high deductible has time on their side. Premium savings compound over years, and statistically, they’re less likely to face major health events in the near term. A 72-year-old making this decision for the first time is in a different situation. The window to accumulate savings is shorter, and the risk of needing that deductible sooner is higher. I’d lean toward standard Plan G in that case.

Also worth knowing: the 2026 Part A deductible is $1,676 per benefit period, not per year. That’s a significant cost-sharing exposure if you’re hospitalized, and it counts toward your high deductible plan’s deductible. So a hospital admission gets you partway there fast. For people who’ve been hospitalized recently or have conditions that make it likely, that context matters.

One more thing. Some insurers let you pair a high deductible Medigap plan with a Medicare Savings Account, though these are rare and come with their own rules. It’s worth asking your insurance agent if that’s available in your state, because it can make the high deductible option even more attractive from a tax standpoint.

Bottom Line

If you’re 65, in decent health, and have some savings to cover a bad year, High Deductible Plan G is genuinely worth serious consideration. Most people dismiss it without running the numbers, and that’s a costly reflex. That said, if unpredictable medical bills would cause you real financial or emotional stress, the peace of mind from standard Plan G has real value too, and there’s no shame in paying for that.

Frequently Asked Questions

Can I switch from High Deductible Plan G to standard Plan G later?

In most states, switching after your Medigap open enrollment period requires medical underwriting. That means if your health has changed, an insurer can decline you or charge more. A few states have additional protections, but don’t count on being able to switch freely. Make this decision carefully upfront.

Does the high deductible apply to Part A and Part B separately?

No. The $2,870 deductible (2026) for High Deductible Plan G is a combined threshold. All Medicare-approved cost-sharing you pay counts toward it, whether it’s from Part A (hospital) or Part B (outpatient). Once you hit the combined total, the plan covers everything Plan G normally covers for the rest of the year.

Are there situations where neither Plan G option is the right call?

Yes. Plan N is worth a look if you want something between the two. It has lower premiums than standard Plan G but doesn’t have the full deductible of High Deductible Plan G. You pay up to $20 per office visit and up to $50 for emergency room visits that don’t lead to inpatient admission. For people who rarely see specialists, it can be a good middle path.

What if I have a chronic condition but still want to save money on premiums?

This is where you need to be honest with yourself about your annual healthcare usage. If your condition means you’re regularly seeing specialists, getting imaging, or have any history of hospitalizations, you’re likely to hit or approach the high deductible in many years. In that case, standard Plan G or Plan N will almost certainly save you money over time. The math just works differently when your out-of-pocket costs are consistently high.

Your Medigap Premium Will Not Stay the Same — Ever

Most people shopping for a Medicare supplement plan assume their premium is basically locked in once they enroll. It’s not. In fact, one of the most expensive surprises in retirement healthcare is watching a $120/month Medigap premium slowly become $280/month by the time you’re in your late 70s. That’s not a scare tactic — that’s just how the pricing works.

There are a few different reasons your premium climbs over time, and they don’t all get equal attention. Age increases are the big one. But there’s also general medical inflation, insurer-specific rate adjustments, and the rating method your plan uses. Understanding all four is the difference between making a smart long-term choice and getting blindsided.

I’ve helped a lot of people work through this, and I’ll tell you right now: most of the confusion comes from not knowing which type of rate increase is actually hitting them. So let’s break it down clearly.

The Three Pricing Methods Determine How Much Age Hurts You

Every Medigap policy uses one of three “rating” methods to set its premiums. This is the single most important thing to understand before you buy a plan, because it determines exactly how your costs will grow as you age.

Community-rated plans charge the same premium to everyone in the policy, regardless of age. A 65-year-old and a 75-year-old on the same plan from the same insurer pay the same monthly amount. These plans still go up over time because of inflation and medical trend factors, but your individual age doesn’t directly increase your rate. If you can find one, this is generally the best deal as you get older.

Issue-age-rated plans base your premium on how old you were when you first bought the policy. Your rate is locked to that entry age, so the 65-year-old pays less than someone who enrolled at 70 — but your age at 72 or 75 doesn’t directly jack up your rate. Like community-rated plans, these still increase for inflation, but not because you had a birthday.

Attained-age-rated plans are the most common, and in my opinion, the most problematic for people who don’t understand what they’re signing up for. Your premium is based on your current age, and it goes up every year as you get older. These plans often look the cheapest at 65, which is exactly why insurers love selling them. But by 72, 75, or 80, you’re paying a lot more than you would under a community-rated plan.

Here’s a simplified comparison of how these three methods play out over time for the same Plan G coverage:

Age	Community-Rated (est.)	Issue-Age-Rated (est.)	Attained-Age-Rated (est.)
65	$160/mo	$140/mo	$120/mo
70	$175/mo	$155/mo	$165/mo
75	$195/mo	$175/mo	$215/mo
80	$215/mo	$195/mo	$275/mo

These are estimates based on typical market patterns, not quotes from a specific insurer. But the trend is real. The attained-age plan that looked $40 cheaper at 65 costs $60 to $80 more per month by 80. Over 15 years, you’ve paid thousands more than the community-rated plan that seemed pricier upfront.

Age Increases Are Just One Layer — Medical Inflation Hits Everyone

Here’s something that trips people up: even if you’re on a community-rated or issue-age-rated plan, your premium is still going up every year. It’s not because you’re older. It’s because healthcare costs more every year, your insurer paid out more in claims, and they need to recapture that through higher rates.

These are called “trend increases,” and they typically run 3% to 6% per year depending on the insurer and the state. On top of that, if you’re on an attained-age plan, you’re absorbing your age increase on top of the trend increase. Those two numbers stack.

A 68-year-old in Ohio on an attained-age Plan G might see a 4% trend increase plus a 3% age bump in the same year. That’s a 7% rate hike in 12 months. And because the insurer doesn’t have to split those out on your rate notice, it just looks like one big jump with no explanation.

States do have some oversight of rate increases. Insurers have to justify their requested hikes to state insurance departments, and increases can be denied or reduced. But in practice, most increases go through. Some states have more aggressive consumer protections than others. New York and Connecticut, for example, only allow community-rated Medigap plans, which removes the age component entirely.

The Biggest Mistake People Make When Shopping for Medigap

I see this constantly, and it costs people real money: choosing a Medigap plan based only on the current monthly premium without asking what rating method the insurer uses.

I understand why it happens. You’re comparing quotes, everything looks like a commodity, and the $25/month difference between two Plan G policies feels like an obvious choice. But if the cheaper plan is attained-age-rated and the more expensive one is community-rated, that “savings” almost certainly disappears within four or five years.

Worse, by the time those rates have diverged significantly, you may not be able to switch. Outside of your initial enrollment window, Medigap insurers can medically underwrite you in most states. That means if you’ve been diagnosed with anything significant in the years since you first enrolled, you might be locked into your current plan whether you like it or not.

The only guaranteed time to switch plans without medical questions is during your Medigap Open Enrollment Period, which is the six months that start the month you turn 65 and are enrolled in Medicare Part B. After that window closes, you’re subject to underwriting in most states, and a lot of insurers will decline coverage or add riders that exclude pre-existing conditions.

This is why it matters so much to think about the 15-year picture when you’re 65, not just what you’re paying this month.

What You Can Actually Do to Control Long-Term Costs

You’re not completely powerless here. There are a few real strategies that work.

First, find out the rating method before you buy. Ask the insurer directly or ask your broker. It should be disclosed in the policy documents. If someone can’t tell you, that’s a red flag.

Second, compare insurers, not just plan letters. Plan G from Insurer A covers the exact same things as Plan G from Insurer B. The coverage is standardized by federal law. The only differences are price, rate history, and the company’s financial stability. Look up rate increase history. Some brokers have access to this data. Ask.

Third, consider high-deductible Plan G if you’re in good health. The 2026 deductible for high-deductible Plan G is $2,870. If you meet that deductible, it pays the same things as regular Plan G after that point. Premiums are often 50% to 60% lower, and the age-related increases, while they still exist, are applied to a much smaller base number. A 67-year-old in decent health paying $55/month for high-deductible Plan G is in a very different position than someone paying $145/month for standard Plan G.

Fourth, if you’re in a state with community-rated rules, pay attention to that. In New York, for instance, your premium doesn’t go up because you got older. Inflation increases still happen, but you’re not penalized purely for aging. That’s a meaningful structural advantage.

One thing I’ll say clearly: don’t drop your Medigap plan to save money on premiums without thinking this through very carefully. Original Medicare alone exposes you to the Part A deductible (which is $1,676 per benefit period in 2026), 20% of all Part B costs with no out-of-pocket maximum, and potentially crushing costs if you’re hospitalized multiple times in a year. The premium feels expensive until you’re faced with what Medigap actually covers.

Bottom Line

If you’re choosing a Medigap plan at 65, don’t optimize for the lowest premium today. Look at the rating method, look at the insurer’s rate increase history, and think about where you’ll be financially at 75 or 80 when healthcare costs tend to go up. For most people, a community-rated or issue-age-rated Plan G from a financially stable insurer is the smarter long-term choice, even if it costs a bit more upfront.

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Frequently Asked Questions

Do Medicare supplement premiums go up every year?

Yes, in practice they do for nearly everyone. Whether it’s an age-based increase, a general trend increase from rising healthcare costs, or both, you should expect your premium to be higher next year than it is today. The only question is how much, and that depends heavily on which rating method your plan uses and which state you live in.

Can I switch Medigap plans if my premiums get too high?

Maybe, but not always. Outside of your initial open enrollment period, most states allow insurers to ask medical questions and deny coverage based on your health history. If you’re healthy, switching is often possible and can save you money. If you’ve developed health conditions since you first enrolled, you might not qualify for a different plan. This is exactly why it matters to choose wisely at 65 rather than assuming you can always switch later.

What’s the average rate increase for Medigap plans per year?

There’s no single national average that covers all plans and all insurers, but a reasonable expectation for most attained-age-rated plans is 4% to 8% per year when you combine age increases and medical trend. Community-rated and issue-age-rated plans tend to run lower, typically in the 3% to 5% range for trend alone. Actual increases vary by state and insurer, which is why checking a specific company’s rate increase history before you buy is worth doing.

Does Plan G premium increase with age more than other Medigap plans?

Not necessarily more than other plans, but Plan G is one of the most popular options, so it gets the most attention. Any Medigap plan using attained-age rating will see age-based increases. The plan letter itself (G, N, etc.) doesn’t determine how aggressively rates increase. The rating method and the insurer’s business decisions do. That said, Plan N often starts cheaper and can be a reasonable alternative for people willing to pay some cost-sharing in exchange for lower long-term premiums.

Your Medicare supplement premium isn’t locked in forever

Most people sign up for a Medigap plan at 65, pay the same insurer for the next decade, and never look back. That loyalty costs them, on average, hundreds of dollars a year. I’ve watched people overpay by $600 to $1,200 annually simply because they assumed they couldn’t change plans or didn’t know the rules well enough to try.

The good news: there are real, legal strategies to reduce what you’re paying after retirement. Some require timing. Some require a little paperwork. A few require you to be honest with yourself about your health. But they’re not complicated, and I’m going to walk you through what actually works.

Before anything else, understand this: Medicare supplement premiums are not federally regulated for price. The government standardizes the benefits (Plan G is Plan G, no matter who sells it), but insurers set their own rates. That’s the root cause of both your problem and your opportunity.

Shop your current plan against the competition every two to three years

This is the most direct thing you can do, and most people never do it. If you’re on Plan G right now and you enrolled at 65, your insurer has almost certainly raised your rates multiple times since then. Meanwhile, a competitor might be offering the same Plan G benefits for $40 or $50 less per month to someone your current age in your state.

Here’s the thing. The benefits are identical. Plan G from Mutual of Omaha pays the exact same claims as Plan G from AARP/UnitedHealthcare or Cigna. The standardization rules guarantee it. So when you’re comparing, you’re purely comparing price and insurer stability.

In 2026, Plan G premiums for a 67-year-old vary significantly by state and insurer. In Ohio, you might see quotes ranging from $115 to $185 per month for the same plan. In Florida, that range can stretch from $150 to $230. If you enrolled years ago with a company that’s since raised rates aggressively, you could easily be sitting at the high end of that range for no good reason.

Use Medicare’s Plan Finder tool or a broker who works with multiple carriers. Don’t rely on a single company’s website. And when you get quotes, make sure you’re comparing the same plan letter. A cheaper Plan N is not an apples-to-apples comparison to Plan G.

Understand when you can switch (and when you can’t)

Here’s where it gets real, and where I see the most frustration. Outside of a few specific windows, you have no guaranteed right to switch Medigap plans. Insurers in most states can ask about your health history, and they can deny you or charge more based on pre-existing conditions.

That’s a hard truth. But it doesn’t mean you’re stuck forever.

If you’re in relatively good health, you can apply to switch plans any time. Insurers will underwrite you, meaning they’ll ask questions about your health. If you’re healthy, you’ll likely be approved. The catch is that “healthy” is a low bar. Many people in their late 60s who think of themselves as having “a few issues” are still approvable for a new Medigap plan.

There are also guaranteed issue windows that don’t require underwriting at all. These include situations like your Medicare Advantage plan leaving your service area, or you losing employer coverage. If you qualify for one of these windows, use it. You won’t need to answer a single health question.

A few states, including New York, Connecticut, and Massachusetts, have their own rules that give you stronger switching rights year-round. If you live in one of those states, you’re in a better position than most to switch whenever rates get unreasonable.

Consider whether Plan G High-Deductible is right for you now

This is a strategy that makes a lot of sense for a specific type of person, and I want to be direct about who that is.

Plan G High-Deductible works exactly like standard Plan G, but you pay all costs out-of-pocket until you hit the annual deductible. In 2026, that deductible is $2,870. After that, the plan covers everything Plan G covers. In exchange for taking on that deductible risk, your monthly premium drops substantially. A 67-year-old in Ohio who’s paying $155/month for standard Plan G might pay $55 to $70/month for Plan G High-Deductible.

That’s a difference of roughly $85 to $100 per month, or $1,020 to $1,200 per year in premium savings. If you stay healthy and your actual out-of-pocket costs are low, you come out ahead every year. The break-even point is typically somewhere around $1,500 to $2,000 in annual medical costs, which many healthy retirees don’t reach.

The plan is not right for everyone. If you have ongoing conditions that require regular specialist visits, hospitalizations, or expensive procedures, the standard Plan G is almost certainly worth the higher premium. But if you’re in good health, have some savings as a cushion, and are watching your monthly cash flow carefully, High-Deductible Plan G is genuinely worth running the numbers on.

Plan	Typical Monthly Premium (Age 67, Ohio)	Annual Deductible Before Full Coverage	Best For
Plan G (Standard)	$115 – $185	$257 (2026 Part B deductible only)	Frequent medical users, peace of mind seekers
Plan G High-Deductible	$55 – $80	$2,870 (2026 HD deductible)	Healthy retirees with savings reserves
Plan N	$80 – $135	$257 (2026 Part B deductible) + copays	Low-to-moderate users comfortable with small copays

The biggest mistake I see retirees make about Medigap costs

People assume that staying with the same insurer for years earns them some kind of loyalty benefit. It doesn’t. In fact, the opposite is often true.

Insurance companies know that the longer you stay on a plan, the less likely you are to leave. They count on inertia. Rate increases happen gradually, just enough each year to not shock you into action. But compounded over four or five years, that adds up. I’ve talked with people who were paying $210 a month for a plan that a new customer could get for $140. Same insurer. Same plan letter. Different enrollment date and different rate class.

This happens because many insurers price newer enrollees more competitively to win business, while incrementally raising rates on existing policyholders. It’s called “attained-age” rating behavior even when plans are technically “issue-age” rated, because there’s nothing stopping a company from raising everyone’s rates in a given block of policyholders.

The fix is simple: don’t assume your rate is competitive just because you’ve always paid it. Call a broker once every two to three years and ask them to run your current age and zip code against the market. This takes about 20 minutes and can save you $600 to $1,500 a year if your plan has drifted high.

The second most common mistake is dismissing Plan N out of hand. A lot of people heard about Plan F or Plan G and stopped there. Plan N has small copays (up to $20 for office visits and up to $50 for ER visits that don’t result in an inpatient admission), but the premiums are meaningfully lower. For someone with three or four doctor visits a year, those copays total maybe $60 to $80 annually, while the premium savings might be $400 to $600. The math often favors Plan N for moderate users.

Bottom line

If you want to lower your Medicare supplement costs after retirement, the single most effective thing you can do is shop your current plan against the market right now, not next year. For most healthy retirees in their late 60s who enrolled at 65 and haven’t looked since, switching to a lower-cost insurer offering the same plan letter will save money immediately with zero change in coverage. If your health allows it, also price out Plan G High-Deductible or Plan N. One of those three moves will almost certainly cut your costs.

Frequently asked questions

Can I switch Medicare supplement plans any time I want?

In most states, you can apply to switch any time, but insurers can deny you based on your health history outside of guaranteed issue windows. If you’re healthy, you’ll likely be approved. If you live in New York, Connecticut, or Massachusetts, you have stronger year-round rights to switch without underwriting.

Will switching Medigap plans cause a gap in my coverage?

No, if you time it correctly. Coordinate your new plan’s start date to begin the day after your old plan ends. Don’t cancel your current plan until the new one is confirmed and approved in writing. A broker can help you sequence this so there’s no coverage gap.

Is Plan G High-Deductible a good idea if I have diabetes or high blood pressure?

It depends on how well-controlled those conditions are and how often you’re actually using medical care. If you’re seeing specialists regularly and getting frequent labs or imaging, the $2,870 deductible on the High-Deductible plan could hit you every single year. Run your actual medical costs from the past two years, and compare total out-of-pocket plus premium for each option. For many people with managed chronic conditions, standard Plan G still wins.

Does my Medicare supplement premium go up every year automatically?

Not automatically, but in practice, yes, most plans increase annually. How much depends on your insurer, your state, and how your insurer prices its policies (attained-age, issue-age, or community-rated). This is exactly why shopping the market every few years matters. The company with the best rate at 65 is often not the best value at 70.

Yes, But Most People Won’t See a Dime Back

Medicare supplement premiums are tax deductible — technically. The IRS counts them as a medical expense, which means they can reduce your taxable income. But here’s the thing: the rules around medical expense deductions are strict enough that the majority of retirees never actually get a benefit from this. I don’t want you to spend the next hour organizing receipts based on a half-true answer you read somewhere else.

Let me walk you through exactly how it works, who it actually helps, and what most people get wrong about it.

How the Medical Expense Deduction Actually Works

The IRS allows you to deduct medical expenses — including Medigap premiums — under Schedule A of your federal tax return. But there’s a catch that eliminates most people before they even get started: you can only deduct the portion of your total medical expenses that exceeds 7.5% of your adjusted gross income (AGI).

So if your AGI is $50,000, your medical expenses need to top $3,750 before you can deduct even a single dollar. And you only get to deduct what’s above that threshold, not the whole amount.

Here’s a real example. Say you’re a 67-year-old in Ohio paying $145 a month for Plan G. That’s $1,740 a year in Medigap premiums. Add your Part B premium (the standard 2026 rate is $185 a month, so $2,220 a year), and you’re at $3,960 in combined premiums alone. On a $50,000 AGI, your threshold is $3,750, so you’d be looking at a deductible amount of about $210. That’s not nothing, but it’s unlikely to make a meaningful difference in your tax bill.

Now add out-of-pocket costs — dental work, hearing aids, prescription drugs, medical travel — and the picture can shift. For people with significant health expenses in a given year, this deduction becomes genuinely useful. But for someone who’s relatively healthy and has a modest income, it probably won’t move the needle.

There’s also the standard deduction to consider. In 2026, the standard deduction for a single filer aged 65 or older is $16,550, and for a married couple both 65 or older, it’s around $30,600. If your itemized deductions — including that medical expense figure — don’t beat the standard deduction, you’re taking the standard deduction anyway, and your Medigap premiums are effectively not helping you at all.

What Counts (and What Doesn’t)

If you do decide to itemize, it helps to know what you can bundle into that medical expense total. The IRS is broader than most people expect here.

Eligible medical expenses you can add to your Medigap premiums include:

• Medicare Part B premiums
• Medicare Part D premiums
• Medicare Advantage premiums (if applicable)
• Long-term care insurance premiums (up to age-based limits)
• Dental and vision care costs
• Prescription drug costs not covered by insurance
• Medical equipment like wheelchairs or hearing aids
• Mileage driven to medical appointments (the 2026 medical mileage rate is 21 cents per mile)
• Amounts paid to doctors, hospitals, and specialists after insurance pays its share

What doesn’t count: gym memberships (even if your doctor recommended exercise), cosmetic procedures, over-the-counter medications in most cases, and health expenses that were reimbursed by insurance.

The bundling matters. If you had a significant health event in 2026 — a hospitalization, major surgery, expensive dental work — you might find that your total medical expenses clear that 7.5% threshold by a wide margin. In those situations, tracking every deductible expense including your Medigap premiums is worth doing.

The Mistake I See People Make All the Time

I’ve talked to a lot of Medicare beneficiaries who believe they’re deducting their Medigap premiums when they’re actually not. Here’s how it happens.

They hear that Medigap premiums are tax deductible, so they list them on their taxes. Their tax software or their accountant dutifully notes the amount. But because their total itemized deductions don’t exceed the standard deduction, the software automatically selects the standard deduction. The Medigap premiums never actually reduced their tax bill. They got no benefit from the deduction at all.

This isn’t a mistake that costs you money in extra taxes — you’re not doing anything wrong. But it can create a false sense of confidence. People think they’re getting a tax break on their Medicare supplement, when really they just did extra paperwork for nothing.

The only way this deduction genuinely helps you is if you’re itemizing, and your itemized total beats your standard deduction. If you’re not sure which applies to you, a tax professional can tell you in about five minutes.

There’s a related misconception worth clearing up: some people think they can deduct Medigap premiums directly from their Social Security income, reducing it dollar for dollar. That’s not how it works. Social Security isn’t reduced by medical expenses — Part B premiums are deducted automatically from Social Security payments, but that’s just how the billing works, not a tax deduction.

Who Actually Benefits From This Deduction

In my experience, two groups of people tend to get real value from deducting Medicare supplement premiums.

The first group is people with higher-than-average medical costs in a given year. If you had a hip replacement, significant dental reconstruction, or started paying for hearing aids in 2026, your medical expenses might already be well above that 7.5% AGI threshold. At that point, adding your Medigap premiums to the pile makes the deduction larger and your tax bill smaller.

The second group is people with relatively lower incomes. The 7.5% threshold is based on your AGI, so someone with an AGI of $25,000 only needs $1,875 in medical expenses before the deduction kicks in. On that income, $1,740 in Medigap premiums plus their Part B premium gets them past the threshold quickly. Combined with other medical costs, the deduction can be meaningful.

Here’s a comparison that makes this clearer:

Scenario	AGI	7.5% Threshold	Total Medical Expenses	Deductible Amount
Healthy retiree, average income	$55,000	$4,125	$3,960	$0
Retiree with major surgery	$55,000	$4,125	$11,500	$7,375
Lower-income retiree	$24,000	$1,800	$4,200	$2,400
Higher-income retiree	$90,000	$6,750	$4,200	$0

The numbers in the table are estimates using typical 2026 premium figures. Your actual situation depends on your specific expenses and income.

One more group worth mentioning: self-employed people who are on Medicare. If you’re still running a business and paying for your own health insurance, different rules may apply. Self-employed individuals can sometimes deduct 100% of health insurance premiums above the line — meaning you don’t have to itemize. Talk to a tax professional if this is your situation, because it changes things considerably.

Bottom Line

For most retirees, the Medicare supplement premium deduction sounds better than it actually is. If you’re taking the standard deduction — and most people over 65 are — this deduction isn’t doing anything for you, regardless of how much you paid in Medigap premiums. That said, if you had significant medical expenses in a given year, or if your income is lower, it’s absolutely worth tracking every dollar and running the numbers with a tax pro before you file.

Frequently Asked Questions

Can I deduct my Medicare supplement premium if I don’t itemize?

No. The medical expense deduction only applies when you itemize on Schedule A. If you take the standard deduction — which most people over 65 do — you can’t separately deduct your Medigap premiums. There’s no above-the-line deduction available for Medigap premiums unless you’re self-employed, in which case different rules may apply.

Do Medicare Advantage premiums get the same tax treatment as Medigap premiums?

Yes, they’re treated the same way by the IRS. Both are considered medical insurance premiums and qualify as medical expenses under Schedule A. The same 7.5% AGI threshold applies, and the same standard deduction issue applies. The type of supplement coverage you have doesn’t change the basic rules.

Are Medigap premiums deductible in all states?

At the federal level, the rules are the same everywhere. Some states have their own income tax rules that may be more generous — a handful of states allow medical expense deductions at a lower threshold than 7.5%, and a few states have no income tax at all. It’s worth checking your state’s specific rules, especially if you live somewhere like Arizona, Colorado, or Montana that has its own medical deduction structure.

What if my spouse and I both have Medigap policies — can we deduct both premiums?

Yes, you can combine both sets of premiums when calculating your total medical expenses on a joint return. If you’re both paying $145 to $175 a month for your respective Plan G policies, that’s $3,480 to $4,200 a year combined just from Medigap, before you add Part B premiums, Part D costs, and any out-of-pocket expenses. On a joint return with the higher married standard deduction, you’ll still need your total itemized deductions to beat roughly $30,600 in 2026 to get any benefit from itemizing at all.

Why Your State Changes Everything About Medigap Pricing

The cheapest Medicare supplement plan in Florida might cost nearly twice what someone in Iowa pays for the exact same coverage. That’s not a typo. State rules, insurer competition, and even local healthcare costs all pile on top of each other to create wildly different pricing across the country.

Here’s the thing: Medigap benefits are federally standardized. A Plan G in Texas covers the same things as a Plan G in New Jersey. The plan letter is the same. The benefits are identical. But the premium? That’s where states diverge in a big way, and if you don’t understand why, you’ll never know whether the quote you’re getting is a good deal or a rip-off.

Three states don’t even use the standard lettered plans. Massachusetts, Minnesota, and Wisconsin have their own Medigap frameworks, which means if you live in one of those states, most of the general advice you’ll read online doesn’t apply to you cleanly. You need to look at what’s available in your specific state before anything else.

For everyone else, the biggest pricing variables come down to how insurers in your state are allowed to set rates. Some use community rating, which charges everyone the same regardless of age. Others use issue-age rating, which locks your rate based on how old you are when you buy. And then there’s attained-age rating, the most common type, where your premium goes up as you get older. Attained-age policies often look cheap at 65 and get expensive fast. I’ve seen people surprised by this at 72. Don’t be one of them.

The States Where You’ll Find the Best (and Worst) Deals

I want to be direct here because I’ve seen too many articles dance around this. Some states genuinely have better Medigap pricing than others, and it has a lot to do with insurer competition and state regulation.

States like Ohio, Missouri, and Indiana consistently show up with lower Plan G premiums. A 65-year-old woman in Ohio can often find a Plan G for $110 to $135 per month in 2026. That’s a solid deal. In contrast, a 65-year-old woman in New York, which mandates community rating (meaning everyone pays the same), might pay $250 or more per month for the same plan because younger, healthier people aren’t buying in to balance the risk pool.

Community rating sounds fair, but it makes premiums expensive at age 65 and doesn’t reward you for buying early. Issue-age rating is better if you’re buying young and healthy. Attained-age rating is cheapest upfront but carries the most long-term risk.

Here’s a rough comparison of what a 65-year-old female non-smoker might pay for Plan G in 2026 across a handful of states:

State	Rating Method	Estimated Plan G Monthly Premium (Age 65)
Ohio	Attained-age	$110 – $135
Missouri	Attained-age	$115 – $140
Florida	Attained-age	$155 – $200
California	Attained-age	$145 – $190
New York	Community	$240 – $310
Connecticut	Community	$220 – $280

These are estimates based on typical market pricing in 2026. Your actual quote will vary by insurer, your exact age, and whether you use tobacco. But the directional differences are real and consistent.

The Biggest Mistake People Make When Shopping by State

I’ve seen this happen dozens of times. Someone gets one quote from one insurer, assumes it’s the going rate in their state, and signs up. They leave hundreds of dollars a year on the table because they didn’t shop around.

Here’s the misconception: because Plan G benefits are standardized, people assume the price must be standardized too. It absolutely is not. In any given state, the same Plan G from five different insurers can have a 40 to 50 percent price difference for the same person. That’s not a small gap. On a $170/month plan, you might find another insurer offering the same coverage for $120. That’s $600 a year, or $6,000 over ten years.

The other mistake is confusing “affordable” with “low premium.” Plan N, for example, has lower premiums than Plan G in every state. But it also comes with copays (up to $20 per doctor visit, up to $50 for an ER visit that doesn’t lead to inpatient admission) and doesn’t cover the Part B excess charges that some doctors bill above Medicare’s approved amount. If you see four or five doctors regularly, those copays add up. Plan N makes sense for someone who’s healthy and rarely uses outpatient care. It makes less sense for someone managing a chronic condition.

Plan G covers the 2026 Part B deductible ($257) and then pays 100% of everything else Medicare approves. That predictability has real value, and for most people I talk to, Plan G ends up being the better deal once you factor in actual usage.

How to Actually Shop for the Best Rate in Your State

Start with your state’s Department of Insurance website. Most states publish a Medigap rate comparison tool or at least a list of licensed insurers. It won’t always have the cheapest price listed, but it tells you who’s operating in your state, which is your starting point.

Then use an independent broker. Not a captive agent who only sells one company’s products. An independent broker can pull quotes from 10, 15, even 20 insurers at once and show you the spread. That spread is where your savings hide. You want someone who’s appointed with multiple carriers, not someone who works for AARP/UnitedHealthcare or Mutual of Omaha exclusively.

When you’re comparing quotes, look at more than just the current premium. Ask the broker for the insurer’s rate increase history over the last five years. Some insurers come in cheap and then spike rates aggressively at year two or three. Others maintain steadier increases. In my experience, the household discount is also worth asking about. Many insurers offer 7 to 12 percent off if another person in your household also has a Medigap policy with them, even if it’s a different plan.

A few specific things to check:

• Does the insurer have a strong financial rating (A or better from AM Best)?
• What’s the rate increase history in your specific state over the last five years?
• Is there a household discount available?
• Are you in your Open Enrollment period, or will you face medical underwriting?

That last point matters a lot. Your six-month Medigap Open Enrollment window starts the month you’re both 65 and enrolled in Medicare Part B. During that window, no insurer can turn you down or charge you more for pre-existing conditions. Outside that window, in most states, they can. This is why buying at the right time matters as much as buying the right plan.

Plan G vs. Plan N by State: Which One Actually Saves You Money

This is worth its own section because the answer is genuinely different depending on where you live and how often you use healthcare.

In states where Plan G premiums are already low, like Ohio or Indiana, the monthly savings from dropping to Plan N might only be $20 to $30. Given that Plan N has copays and doesn’t cover excess charges, you’d need to have very few doctor visits per year to come out ahead. For a 67-year-old in Ohio with two or three specialist visits a year, Plan G is almost certainly the better deal once you do the math honestly.

In higher-cost states like Florida or New York, the premium gap between Plan G and Plan N widens. In those states, Plan N can make more financial sense for healthier people, because the $40 to $60 monthly savings might genuinely exceed what you’d pay in copays annually.

One more thing on excess charges: they’re more common in some states than others. In states that prohibit excess charges (like Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont), the difference between Plan G and Plan N shrinks further, because one of Plan G’s key advantages disappears. If you’re in one of those states, Plan N becomes a more competitive option than it otherwise would be.

Bottom Line

For most people turning 65, Plan G is the right Medigap choice. It’s predictable, it covers almost everything Medicare doesn’t, and in most states it’s priced reasonably enough that the protection is worth it. Shop at least five to seven insurers in your state using an independent broker, ask about rate history, and don’t skip the household discount question. If you’re in a state that prohibits excess charges and you’re in good health, look seriously at Plan N, but run the actual numbers before assuming the lower premium makes it cheaper.

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Frequently Asked Questions

Can I buy Medigap from an insurer in another state to get a lower price?

No. Medigap policies are regulated at the state level, and insurers are licensed to sell in specific states. You have to buy from an insurer licensed in the state where you live. If you move states later, your coverage continues, but your premium will be re-rated based on the new state’s rules.

Does Medicare Advantage affect my ability to get Medigap later?

Yes, and this is a big deal. If you enroll in Medicare Advantage instead of Medigap at 65 and later want to switch, you lose your guaranteed issue rights in most states. You’ll face medical underwriting, and if you have any serious health conditions, you could be denied or charged significantly more. This is one of the main reasons I generally advise people to think hard before choosing Advantage over Medigap at age 65.

How much does Plan G cost in 2026?

Plan G premiums for a 65-year-old in 2026 typically range from about $100 to $200 per month, depending on your state, the insurer, and whether you use tobacco. After you pay the 2026 Part B deductible of $257 for the year, Plan G covers 100% of Medicare-approved costs for the rest of that calendar year. The variation between states and insurers is wide enough that shopping around is genuinely worth your time.

What if I have low income? Are there cheaper Medigap options?

If your income is limited, Medicare Savings Programs at the state level might help with Part B premiums, and Medicaid may cover some costs that Medigap would otherwise cover. For people who qualify for both Medicare and Medicaid (dual eligibles), a standalone Medigap policy may not be necessary at all. It’s worth calling your State Health Insurance Assistance Program (SHIP) counselor, which is a free service available in every state, to walk through your specific situation before you buy anything.