Your friend informs you that they've enrolled in a Medigap plan for a premium of $150, piquing your interest as you are also considering enrolling in the same plan. However, upon checking, you realize the same plan will cost you $200. This discrepancy can lead to confusion and raise questions about the factors that contribute to the varying premiums of Medigap plans.
Let's find out whether Medigap premiums vary, identify the factors that influence its pricing, and understand how insurance companies arrive at the cost of your plan.
A Medigap plan, also known as a Medicare Supplement plan
Medigap plans work alongside Original Medicare and are sold by private insurance companies. This means you need to have Medicare Parts A & B to be eligible to enroll in a Medigap plan.
These plans are standardized by the federal government and come in ten options (in most states), identified as Plans A, B, C, D, F, G, K, L, M, and N. Each plan offers a unique level of coverage to accommodate different healthcare needs.
It's important to note that some states, such as Wisconsin Massachusetts Minnesota
To enroll in a Medigap plan, you will typically have to pay the plan premium and the Part B premium, as well as any deductibles, copays, and coinsurances associated with your chosen plan. However, the Medigap plan premiums may differ from one person to another. For example, a friend in a different state may pay a different premium amount for your Medigap plan.
Medigap plans
Insurance Company — different companies may charge different premiums for the same Medigap plan.
Plan Type — plans that offer more comprehensive coverage may cost more than those that provide less coverage.
Age — premium amount may increase with age.
Gender — some insurance companies may charge different premiums based on gender.
Location — premiums can vary by state and even by region within a state.
Health Status —individuals with pre-existing medical conditions or those deemed at higher risk may be charged higher premiums.
Smoking Status — some insurance companies may also charge higher premiums to tobacco users.
We have seen the various factors that impact the cost of a Medigap plan. Now let's dive deeper to uncover how these factors influence your Medigap premium.
The Medigap plan premium can vary depending on the insurance company. Various factors, such as administrative costs, underwriting expenses, and profit margins, can influence the premium for the same Medigap plan offered by different insurance companies.
Each insurance company has its own health questions and criteria to determine who they accept for a Medigap plan. Some insurers may loosen their underwriting process to attract more policyholders but may charge a higher premium. On the other hand, insurance companies with more stringent health questions may offer lower premiums.
Furthermore, some insurance companies offer discounts to policyholders who meet specific criteria, such as being a non-smoker. You may also be eligible for discounts if you pay your premiums yearly or use electronic funds transfer to make automatic payments from your checking account or credit card.
Additionally, you may receive a discount if you have multiple policies with the same insurance company.
The Medigap premiums generally increase as the level of coverage provided by the plan increases.
Plans with more comprehensive coverage typically have higher premiums compared to those with less coverage. For example, plans that offer less coverage, such as Plan K or Plan L, usually charge lower premiums than Plan G, which provides more coverage and charges more.
It's important to note that Medigap plans with high deductibles typically have lower premiums than their standard counterparts. However, you'll need to pay a higher deductible before your coverage starts.
Additionally, some insurance companies offer Medicare SELECT policies, which may have lower premiums, but have network restrictions to receive full coverage.
Medigap plans can be priced or "rated" in 3 ways:
Community-rated (No Age-Rated)
With this type of Medigap policy, everyone pays the same premium, regardless of age. For example, Mr. Derek and Mrs. Paula both pay $160 for the same Medigap policy, even though Mrs. Paula is older.
Issue-age-rated (Entry Age-Rated)
Premiums are based on your age when you first buy the Medigap policy. Younger buyers typically pay less than older buyers. For example, Mr. Dan pays $145 because he bought the policy at age 65, while Mrs. Willey pays $175 because she bought the same policy at age 72.
Attained-age-rated
Premiums are based on your current age. They increase as you get older. At first, premiums for this type of policy may be lower, but they will increase over time. For example, Mrs. Henry's premium is $180 when she first buys the policy at age 65, but it increases each year. Mr. Bob, who buys the same policy at age 72, pays $265, and his premium also increases each year as he gets older.
It's important to note that in each of the above cases, the premium amount can increase due to inflation or other factors.
Did you know that your gender could affect your Medigap rates? Some insurance providers may offer reduced rates on Medicare Supplement plans for female policyholders.
As women tend to have better health and file fewer claims on average than men, female beneficiaries generally pay around $10-30 less in monthly premiums than their male counterparts.
The cost of Medigap plans can vary depending on your location. Insurance companies use various factors to calculate Medigap premiums, such as local healthcare service costs, cost of living, and state-specific insurance regulations.
For example, in states like New York and Connecticut, Medigap premiums can be significantly higher compared to other states, often ranging between $300 to $500 per month. This is because these states have year-round open enrollment, allowing applicants to enroll in a Medigap plan without undergoing medical underwriting or answering health-related questions.
On the other hand, Medigap plans in Florida are known to be among the most expensive in the United States. This could be attributed to the state's large population of seniors, resulting in insurance carriers charging higher premiums to meet the increased demand for healthcare services.
Furthermore, there are some states like Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont where laws prohibit excess charges
Medigap premiums are generally not impacted by your health status, provided you enroll during your initial enrollment period or have guaranteed issue rights
However, if you enroll in a Medigap policy after your initial enrollment period has ended, you may need to undergo medical underwriting. This means that the insurance company can consider your health status when determining your premium.
If you have pre-existing conditions or other health issues in this instance, you may be charged a higher premium or even denied coverage altogether.
Due to the increased health risks associated with tobacco use, insurance carriers often charge tobacco users higher premiums. If you smoke, vape or use tobacco products, you can anticipate paying up to 10% more on your monthly Medigap premium than a non-tobacco user.
Medigap Plans are a valuable resource for covering the gaps left by Original Medicare. However, it is important to note that enrolling in a Medigap plan involves paying a plan premium, which can vary based on a variety of factors, including plan type, age, gender, location, health status, and the insurance company. By carefully considering these factors and comparing multiple plans, you can make an informed decision and find a Medigap plan
Comparing Medigap plans our Medicare advisors
How to Deduct Medicare Expenses from Your Taxes
Dec 28, 2022
Does Medicare Cover Macular Degeneration?
Nov 30, 2022
How Much Does Rexulti Cost with Medicare?
Jan 24, 2023
Medicare Explained
Jan 3, 2022
Does Medicare Cover Kyphoplasty?
Dec 9, 2022
What Is the Medicare Birthday Rule in Nevada?
Mar 28, 2023
Does Medicare Cover Mouth Guards for Sleep Apnea?
Dec 8, 2022
What's the Deal with Flex Cards?
Dec 15, 2022
How Are Medicare Star Ratings Determined?
Sep 6, 2023
Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022
What Does Medicare Cover for Stroke Patients?
Jan 20, 2023
Medicare Advantage Plans for Disabled People Under 65
Mar 24, 2023
Is Botox Covered by Medicare?
Jan 19, 2023
Does Medicare Cover Hypnotherapy?
Nov 22, 2022
Does Medicare Cover Boniva?
Nov 29, 2022
When Can You Change Medicare Supplement Plans?
Nov 18, 2022
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Sep 19, 2022
Fair Square Bulletin: We're Revolutionizing Medicare
Apr 27, 2023
13 Best Ways for Seniors to Stay Active in Philadelphia
13 Best Ways for Seniors to Stay Active in Phoenix
14 Best Ways to Stay Active in Charlotte
20 Questions to Ask Your Medicare Agent
Can Doctors Choose Not to Accept Medicare?
Costco Pharmacy Partners with Fair Square
Denied Coverage? What to Do When Your Carrier Says No
Do Medicare Supplement Plans Cover Dental and Vision?
Do You Need Books on Medicare?
Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?
Does Medicare Cover Abortion Services?
Does Medicare Cover Air Purifiers?
Does Medicare Cover an FMT?
Does Medicare Cover Bariatric Surgery?
Does Medicare Cover Bladder Sling Surgery?
Does Medicare Cover Cala Trio?
Does Medicare Cover Cardiac Ablation?
Does Medicare Cover Cervical Disc Replacement?
Does Medicare Cover Chiropractic Visits?
Does Medicare Cover Compounded Medications?
Does Medicare Cover Cosmetic Surgery?
Does Medicare Cover Geri Chairs?
Does Medicare Cover Hearing Aids?
Does Medicare Cover Hepatitis C Treatment?
Does Medicare Cover Hoarding Cleanup?
Does Medicare Cover Incontinence Supplies?
Does Medicare Cover Jakafi?
Does Medicare Cover Krystexxa?
Does Medicare Cover Lipoma Removal?
Does Medicare Cover LVAD Surgery?
Does Medicare Cover Medical Marijuana?
Does Medicare Cover Nexavar?
Does Medicare Cover Nuedexta?
Does Medicare Cover Orthodontic Care?
Does Medicare Cover Penile Implant Surgery?
Does Medicare Cover Robotic Surgery?
Does Medicare Cover RSV Vaccines?
Does Medicare Cover Urodynamic Testing?
Does Medicare Cover Xiafaxan?
Does Medicare Pay for Varicose Vein Treatment?
Does Medicare Require a Referral for Audiology Exams?
Does Your Medicare Plan Cover B12 Shots?
Does Your Plan Include A Free Gym Membership?
Health Savings Accounts (HSAs) and Medicare
How Do Medicare Agents Get Paid?
How Do Medigap Premiums Vary?
How Much Does a Medicare Coach Cost?
How Much Does a Pacemaker Cost with Medicare?
How Much Does Medicare Cost?
How Much Does Trelegy Cost with Medicare?
How to Apply for Medicare?
How to Choose a Medigap Plan
How to Compare Medigap Plans in 2025
Is HIFU Covered by Medicare?
Medicare & Ozempic
Medicare 101
Medicare Supplement Plans for Low-Income Seniors
Medigap vs. Medicare Advantage
The Fair Square Bulletin: October 2023
Top 10 Physical Therapy Clinics in San Diego
Turning 65 and Thinking of Keeping COBRA? Here’s Why It Usually Backfires
Welcome to Fair Square's First Newsletter
What If I Don't Like My Plan?
What is a Medicare Beneficiary Ombudsman?
What Is a Medicare Supplement SELECT Plan?
What is Plan J?
What To Do If Your Medicare Advantage Plan Is Discontinued
What to Do When Your Doctor Leaves Your Network
What You Need to Know About Creditable Coverage
What's the Difference Between HMO and PPO Plans?
Will Medicare Cover Dental Implants?
Will Medicare Cover it?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
MULTIPLAN_FairSquareMedicare_01062022_M
Fair Square Medicare