Medicare Supplement Rates by State (2026)

In a community-rated state, every policyholder pays the same monthly premium for a given Medigap plan — regardless of age. A 65-year-old and a 75-year-old enrolled in the same plan with the same carrier pay the same amount.

Premiums in community-rated states can still increase over time, but those increases are driven by the overall cost of claims across the risk pool — not by your birthday. As a result, community-rated pricing tends to become relatively more affordable compared to other rating types as you get older.

States that use community-rated Medigap pricing include Connecticut, Massachusetts, Minnesota, New York, and Washington, among others. See the state table above to find your state's rating type.

In an issue-age-rated state, your premium is based on the age at which you first enroll in the plan — and it stays anchored to that enrollment age. A person who buys at 65 will always pay the rate associated with age 65, even when they turn 70 or 75.

Premiums in issue-age states can still increase due to inflation and general claims trends, but they will not increase simply because you had a birthday. The earlier you enroll, the lower your starting rate — and that rate base stays with you. Over a long retirement, issue-age pricing is generally more predictable than attained-age pricing.

In an attained-age-rated state — the most common type across the U.S. — your premium is based on your current age and increases as you get older. Attained-age plans typically start at a lower monthly premium than community-rated or issue-age alternatives, but they tend to become more expensive over time as your rate rises with each year of age.

When comparing attained-age carriers, look at the long-term premium trajectory, not just the starting price. A plan that is $20/month cheaper at 65 may cost significantly more by the time you reach 75 or 80.

There is no universal answer. Your state determines which rating systems are available to you — you cannot choose to buy community-rated coverage if your state uses attained-age pricing.

As a general principle: the older you are at enrollment, the more valuable community-rated or issue-age pricing becomes, because you avoid the compounding premium increases that attained-age pricing produces over time. If you are enrolling at 65, an attained-age plan may look attractive at first; if you are enrolling at 70 or switching plans later in life, the long-term cost curve matters more.

A licensed Medicare advisor can model how the premium trajectories compare in your state for your specific age. Compare plans with a UMA advisor at no cost to you.

Yes — under all three rating types, Medigap premiums can and typically do increase over time. The difference is why they increase:

• Attained-age states: premiums rise both because of your age and because of general claims inflation in the carrier's risk pool.
• Issue-age states: premiums can still rise due to claims trends and inflation, but not because you had a birthday.
• Community-rated states: increases are driven by pool-wide claims experience — your age is irrelevant to the calculation.

The frequency and size of premium increases vary by carrier and state. When comparing carriers, it is worth asking about their historical rate-increase patterns — not just the current quoted rate.

The Medigap Open Enrollment Period (OEP) is a one-time, six-month window that begins the first month you are both age 65 or older and enrolled in Medicare Part B. During your OEP, you have the right to buy any Medicare Supplement plan sold in your state — from any carrier — without being subject to medical underwriting. Insurers cannot deny your application, charge you a higher premium due to pre-existing conditions, or impose a waiting period.

Missing your OEP does not mean you can never get Medigap coverage, but in most states you would need to pass medical underwriting afterward — meaning carriers can review your health history, charge more, or decline your application. Enrolling during your OEP is almost always the lowest-risk time to buy.

The Birthday Rule is a state consumer-protection law that gives you an annual window — typically 30 to 60 days around your birthday — to switch Medicare Supplement plans without medical underwriting. During this window, you can move to a plan with equal or lesser benefits from any carrier, even if you have pre-existing conditions.

The Birthday Rule is available in a growing number of states, including California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Missouri, Nevada, Oklahoma, and Oregon, among others. The specific rules — window length, eligible plan types, and benefit comparisons — vary by state.

See the table above or click your state's page to confirm whether a Birthday Rule applies to you and exactly how it works in your state.

In most states, switching Medigap plans after your Open Enrollment Period ends requires passing medical underwriting — meaning the new carrier can review your health history, charge you more, or decline your application.

There are exceptions. Some states have Birthday Rules or Anniversary Rules that create annual guaranteed-issue switching windows. Certain federal life events also trigger a guaranteed-issue right regardless of state (see below). If you are in an attained-age state and seeing annual premium increases, it is worth checking whether a switching rule applies to you before assuming you are locked in.

Guaranteed Issue (GI) means an insurer must accept your Medigap application, cannot charge you more due to your health history, and cannot impose waiting periods — regardless of your health status. Federal law creates GI rights in specific circumstances outside of Open Enrollment, including:

• Your Medicare Advantage plan is leaving your service area or you are moving out of its coverage area.
• You lose employer-sponsored or union health coverage.
• Your Medigap insurer becomes insolvent or commits fraud.
• You enrolled in Medicare Advantage at age 65 and want to switch back to Original Medicare within 12 months ("trial right").

Some states have expanded GI protections beyond the federal floor. Your state's page links to your State Health Insurance Assistance Program (SHIP) for guidance specific to your situation.

An Anniversary Rule allows you to switch Medicare Supplement plans without medical underwriting once per year on the anniversary of your policy — not just on your birthday. Missouri, for example, offers a policy anniversary switching right in addition to its Birthday Rule, giving policyholders two guaranteed switching windows per year.

Anniversary rules are less common than Birthday Rules but are part of a broader trend of states expanding consumer protections beyond the federal minimum. Check your state's page or consult your SHIP to see whether this protection is available to you.

Several factors determine your monthly Medigap premium:

• Plan letter: The plan you choose is the biggest driver. Plan G covers more than Plan N, so it costs more. Plan benefits are standardized by federal law — the same letter covers the same things regardless of carrier.
• Rating type: Whether your state uses community-rated, issue-age, or attained-age pricing determines how your premium changes over time (see the rating law FAQs above).
• Age: In attained-age states, premiums increase as you get older. In issue-age states, your rate is anchored to your enrollment age. In community-rated states, age has no effect on your premium.
• Gender: In most states, women pay lower premiums than men for the same plan.
• Tobacco use: Most carriers charge tobacco users 5% to 50% more than non-tobacco users.
• Geographic area: Rates can vary by ZIP code or county within the same state, reflecting local cost-of-care differences.
• Household discount: Many carriers offer a 5%–12% discount when another person in your household is also enrolled in a Medigap policy.
• Mode of payment: Some carriers offer a small discount for paying annually rather than monthly.

During your Medigap Open Enrollment Period or a Guaranteed Issue right, your health history cannot be used against you — you pay the same rate as any other applicant for the same plan, regardless of pre-existing conditions.

Outside of those windows, most states allow medical underwriting. That means a carrier can review your health history, charge you a higher premium than the standard rate, or decline your application. If you have pre-existing conditions and are outside your OEP, check whether your state's Birthday Rule or another switching protection applies to you before applying to a new carrier.

In most states, carriers are permitted to use gender as a rating factor. Women typically pay lower premiums than men for the same Medigap plan, reflecting differences in claims experience across the risk pool. The size of the gender-based difference varies by carrier and state.

A small number of states prohibit gender-based rating for Medicare Supplement policies. Your state's page notes which rating rules apply.

Many Medigap carriers offer a household discount — typically 5% to 12% off your monthly premium — when two or more people in the same household are enrolled in Medicare Supplement policies. The policies do not need to be the same plan letter, and in some cases do not need to be with the same carrier.

Eligibility rules vary by carrier: some require both policies to be with the same carrier, others extend the discount to any two Medigap policies in the household, and some include domestic partners or non-spouse household members. For a couple where both partners are on Medicare, the household discount can represent meaningful annual savings — always ask about it when comparing carriers.