The Truth About Medigap Premium Increases: What to Expect and How to Manage Them

One of the most common concerns I hear from people considering a Medicare Supplement (Medigap) plan is: "I know it's good coverage now, but what happens when the premium goes up?"

It is a smart question. Medigap premiums do increase over time. But the degree to which they increase — and what drives those increases — depends on several factors that are worth understanding before you enroll.

Three Ways Medigap Is Priced

Attained-age pricing — Common in Alabama, Georgia, and North Carolina, and also available from some Florida carriers. Your premium starts based on your current age and increases each year as you get older. This means premiums are lower at 65 but rise consistently over time. Expect annual increases from two sources: your age (predictable) and general trend (less predictable, based on claims experience across all policyholders).

Issue-age pricing — Also widely available in Florida. Your premium is based on the age you were when you first bought the policy and will not increase solely because you get older, though carriers can still adjust rates for inflation or claims experience.

Community-rated (no-age rating) — Everyone pays the same premium regardless of age or when they enrolled. A few states require this; Florida, Alabama, Georgia, and North Carolina do not. Massachusetts, Minnesota, and Wisconsin use this model.

How Much Do Premiums Actually Increase?

There is no universal answer, but some realistic expectations based on Southeast market patterns:

Age-driven increases: Under attained-age pricing, expect the age-related portion of your premium to rise approximately 2–5% per year as you move through your 60s and 70s, with accelerating increases in your 80s.

Trend increases: Carriers periodically apply rate increases based on claims experience across all policyholders in your state. These vary by carrier and year — typically ranging from 0–8% annually, sometimes more.

Combined effect: A Plan G premium that starts at $120/month at 65 might be $140–$160/month by age 70, $170–$200/month by 75, and $220–$270/month by 80. These are illustrative ranges; your actual premium depends on the carrier, state, and the specific year's rate actions.

Why Different Carriers Have Very Different Rates

Two carriers can sell identical Medigap Plan G coverage — because the benefits are standardized by federal law — yet charge materially different premiums. The differences come from:

Claims experience: Carriers with an older, sicker policyholder pool file for higher rate increases. Carriers that have done a better job of underwriting and attracting healthier enrollees may have lower rate trends.

Reserves and pricing strategy: Some carriers price aggressively at 65 to attract new enrollees, knowing premiums will increase faster later. Others price conservatively with lower long-term rate volatility.

Market size: Larger national carriers (Aetna, UnitedHealthcare, Mutual of Omaha) spread risk across millions of policyholders and often have more stable rate trends. Smaller regional carriers can be more volatile.

This is why getting locked into a "current premium" comparison at enrollment is not enough. Rate history matters.

How to Evaluate a Carrier's Rate History Before You Enroll

Before choosing a Medigap carrier, ask (or have an independent advisor pull) the carrier's rate increase history in your state for the past 5–7 years. Carriers are required to file rate actions with state insurance regulators, and this information is public.

A carrier with a track record of 3–5% annual increases in Florida over the past seven years is a meaningfully different long-term proposition than one that had a 12% rate action two years ago.

Can You Switch Medigap Carriers Later?

In Florida, Alabama, Georgia, and North Carolina, you can switch carriers after your initial enrollment — but medical underwriting applies in most cases. If your health has changed since you first enrolled, you could be denied coverage or charged a significantly higher premium.

Some states (California, Missouri, Illinois, and a handful of others) have enacted "birthday rules" that allow you to switch carriers once per year without underwriting. Florida, Georgia, Alabama, and North Carolina do not currently have birthday rules, though this is periodically debated in state legislatures.

What this means practically: Switching to a cheaper carrier after years on Medigap is possible if you are still in good health, but it is not guaranteed. The older you get and the more health issues you develop, the fewer options you have.

Strategies for Managing Long-Term Medigap Costs

1. Start with the right carrier, not just the lowest premium. If you choose a carrier with a history of large rate spikes over one that is slightly more expensive but rate-stable, you may pay more over time. An independent advisor can pull carrier rate history for your state.

2. Consider the High-Deductible Plan G. In 2026, the HD Plan G option requires you to pay a $2,870 deductible before coverage kicks in. The premiums are significantly lower — sometimes 50–60% less than standard Plan G. For healthy beneficiaries with low utilization, this can be a cost-effective long-term strategy, especially when paired with a Health Savings Account (before Medicare enrollment).

3. Review annually and be prepared to switch if you are healthy. Even if you cannot switch at 80 without underwriting, reviewing each year during AEP and switching at 68 or 70 while still in good health — if rates have diverged significantly — is a legitimate strategy.

4. Do not let Medigap premiums scare you away from Medigap at 65. The first-year Medigap premium is always the lowest it will ever be under attained-age pricing. The people who regret Medigap most are usually those who skipped it at 65, experienced a health change, and found themselves locked into Medicare Advantage with no ability to qualify for Medigap's comprehensive coverage.

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Choosing a Medigap carrier with solid long-term rate stability is something an independent broker can help you evaluate. Schedule a consultation and I will pull rate history for the leading carriers in your state side by side.

Licensed in Florida, Alabama, Georgia, and North Carolina.

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Frequently Asked Questions#

How often can Medigap carriers raise premiums? Most carriers file for rate increases annually or every other year. Increases must be approved by your state's insurance department. There is no legal cap on rate increases in Florida, Georgia, Alabama, or North Carolina, though regulators do review filings.

Can my Medigap plan be cancelled because of my health? No. Once you are enrolled in a Medigap plan, the carrier cannot cancel your policy due to health conditions or age, as long as you continue paying premiums. This is guaranteed renewable coverage.

Is it worth switching Medigap carriers for a lower premium? It can be, if you are still in good health and can qualify through underwriting. But evaluate not just the current premium gap, but also the new carrier's rate history. Switching to a carrier with aggressive pricing and high rate volatility could leave you worse off in 3–5 years.

What happens to my Medigap if my carrier stops offering plans in my state? If a carrier leaves a state market, you receive notification and have a guaranteed issue right to enroll in another Medigap plan (usually any Plan A, B, D, G, K, or L) from another carrier at standard rates, without underwriting. This is one of the few guaranteed issue rights outside of initial enrollment.