What Actually Changes in Medigap Between Plan Years
Your Medigap plan doesn’t get renegotiated every year the way an Advantage plan does, but that doesn’t mean nothing changes. A few things shift annually, and if you’re not paying attention, they can quietly cost you more money than you expected.
The biggest annual changes aren’t in the plan structure itself. They’re in the underlying Medicare costs that your Medigap plan is covering. Here’s the key distinction: Medigap plans are standardized by letter (Plan G is Plan G no matter who sells it), but the gaps they fill shift based on what Medicare sets as its cost-sharing amounts each year. When those numbers go up, your plan is doing more work. When they go down (which is rare), you get a small break.
For 2026, the Part A deductible is $1,676 per benefit period. The Part B deductible is $257. If you have Plan G, you’re covering that Part B deductible yourself, since Plan G covers almost everything except that one deductible. If you have Plan F, Medicare covers it for you. Those aren’t hypothetical numbers. They’re what you’re working with right now, and they’re different from what they were in 2024 or 2025.
Your premium, on the other hand, is set by your insurer, not Medicare. And that’s where things get genuinely complicated.
Premium Increases Are the Change That Hurts Most People
I’ve seen people sign up for a Medigap plan, feel great about their monthly cost, and then act surprised three years later when their premium is 20% higher. The plan didn’t change. Medicare didn’t change it. Their insurer raised the rate, and they had no legal protection stopping it from happening.
Medigap insurers can raise your premium annually for several reasons. Medical inflation is the one they’ll cite. But rating method matters enormously here, and most people don’t know which one their plan uses when they buy it.
- Community-rated plans charge everyone in a geographic area the same premium, regardless of age. Your premium still goes up with inflation, but it won’t balloon just because you’re getting older.
- Issue-age-rated plans lock in your rate based on how old you are when you first buy. Younger buyers get a lower starting rate. It won’t increase just because you age, but inflation increases still apply.
- Attained-age-rated plans increase every year as you get older, on top of any inflation increases. These often have the lowest starting premiums, which is exactly why they’re dangerous for long-term planning.
A 65-year-old in Texas buying an attained-age-rated Plan G at $110 a month might be paying $180 or more by age 75. Same plan. Same benefits. Just an older policyholder. If that person had bought a community-rated plan at $145 a month to start, they’d likely be paying less a decade later, not more.
The honest answer is that attained-age rating is a bad deal for most people who plan to keep their Medigap coverage long-term. The initial savings rarely hold up.
The Mistake People Make When Benefits Get Standardized or Changed
Here’s a misconception I see constantly: people assume that if Congress or CMS makes changes to Medigap plan structures, their existing plan automatically updates to match. It doesn’t. At all.
The last major restructuring happened in 2020, when Plans C and F were closed to people newly eligible for Medicare. Anyone who already had those plans kept them. People turning 65 in 2020 or later couldn’t buy them. That change happened, and plenty of people thought they could still get Plan F because their neighbor had it. They couldn’t.
If new standardization changes come in the future (and there’s always chatter in Washington about modernizing the benefit structure), the same principle applies. Grandfathered plans stay the same. New enrollees get whatever the current rules allow. Your existing plan is a contract. It doesn’t morph based on legislative tinkering.
The flip side is also true, and it matters. If your current plan gets discontinued, you typically have guaranteed issue rights to move to a comparable plan. But outside of that specific scenario, switching plans means going through underwriting if you’re past your initial open enrollment window. And in most states, if you have health conditions, underwriting can mean denial. This is why I tell people to choose their plan carefully the first time rather than assuming they can switch freely later.
What Changes Year to Year: A Side-by-Side Look
To make this concrete, here’s how some of the key numbers and factors shift from one plan year to the next. This isn’t exhaustive, but these are the ones that affect your out-of-pocket costs in a real way.
| Factor | Who Sets It | 2025 Amount | 2026 Amount | Does Your Plan Cover It? |
|---|---|---|---|---|
| Part A deductible (per benefit period) | Medicare/CMS | $1,676 | $1,676 | Plan G, Plan F: yes. Plan N: yes. Plan K/L: partial. |
| Part B deductible | Medicare/CMS | $240 | $257 | Plan F only. Plan G does NOT cover this. |
| Part B excess charges | Set by Medicare rules | Up to 15% above Medicare rate | Up to 15% above Medicare rate | Plan G and Plan F: yes. Plan N: no. |
| Skilled nursing coinsurance (days 21-100) | Medicare/CMS | $209.50/day | $209.50/day | Plan G and Plan F: yes. Plan N: yes. Plan K/L: partial. |
| Your Medigap premium | Your insurer | Varies | Varies (typically 3-8% increase) | N/A |
The Part B deductible jump from $240 to $257 in 2026 isn’t going to wreck your finances. But it’s a real number, and if you’re on Plan G, you’re writing that check yourself in January when you first see a doctor. Plan accordingly.
When to Actually Consider Switching Plans
Most of the time, you should stay put. Switching Medigap plans is not like switching car insurance. There are real consequences if you’ve had any health issues since you first enrolled, because insurers can deny you or charge you more based on your health history in most states. That protection from medical underwriting only exists during specific windows.
That said, there are situations where looking at a switch genuinely makes sense.
- Your premium has increased dramatically and you’re still in good health. If you’re a 68-year-old in excellent health and your attained-age-rated premium has jumped $50 a month in two years, shopping around during a state-specific open enrollment period or guaranteed issue window could save you real money. But you have to qualify medically in most states.
- Your insurer is exiting your market. This is rare, but it happens. If your plan is being discontinued, you get guaranteed issue rights to switch. Don’t ignore those notices.
- You’ve moved to a state with a continuous open enrollment period. A handful of states, including New York and Connecticut, require insurers to offer Medigap plans without medical underwriting year-round. If you live there, switching is much lower-risk.
- Your actual healthcare use has changed significantly. Someone who started with Plan N because they rarely saw doctors but now has a chronic condition might be better served by Plan G. If you can still medically qualify, a switch might make financial sense over a five-year horizon.
I wouldn’t switch plans just because someone told you a better deal exists. Run the actual numbers, factor in your health situation, and think about the next five to ten years, not just next month’s premium.
Bottom Line
For most people, the plan changes that matter most between Medigap years aren’t in your plan document, they’re in your premium and the underlying Medicare cost-sharing amounts. Plan G is still the best option for most new enrollees in 2026: it covers nearly everything, it’s widely available, and it doesn’t expose you to the risk of paying excess charges. If your premiums are climbing faster than inflation and you’re in good health, it’s worth shopping around, but go in with clear eyes about what underwriting means in your state.
Frequently Asked Questions
Can my Medigap plan’s benefits change without my consent?
Technically, insurers can make minor administrative changes, but they can’t strip out standardized benefits without state insurance department approval. The core benefit structure of your plan is protected. What they can and do change is your premium, and they can do that with proper notice, usually 30 days before it takes effect.
Do I have to re-enroll in my Medigap plan each year like with Medicare Advantage?
No. This is one of the biggest differences between Medigap and Medicare Advantage. Your Medigap policy renews automatically as long as you pay your premiums and your insurer stays in your market. There’s no annual election period and no action required on your part to keep your coverage.
If Medicare raises the Part B deductible, does my Plan G premium go up automatically?
Not automatically, no. Your Plan G premium is set by your insurer and is based on their own claims experience, inflation projections, and business decisions. The Part B deductible increase affects how much Plan G holders pay out of pocket at the start of the year (since Plan G doesn’t cover it), but it doesn’t trigger a direct premium increase. Premiums go up for separate reasons.
Can I switch from Plan G to Plan N to save money on premiums?
You can try, but in most states you’ll need to pass medical underwriting. If you’re healthy, it may be worth exploring. Plan N typically costs $20-$40 less per month than Plan G, but it doesn’t cover Part B excess charges, and you’ll pay small copays for some office visits. If you see doctors who don’t accept Medicare assignment, Plan N can actually cost you more. Know what you’re trading before you make that call.
