All premium figures cited are 2026 plan-year rates, drawn from the Maryland Insurance Administration rate guide effective July 1, 2026, and from CMS publications current as of March 2026; rates vary by state, carrier, and underwriting class.
TL;DR — Quick Verdict
- Attained-age rating is the dominant method among carriers, and it is the only one of the three in which your premium rises purely because you had a birthday.
- Washington National’s attained-age Plan G in Maryland costs a male preferred applicant $251 monthly at 65 and $633 at 85 — a 152% increase driven by the age curve alone.
- Physicians Life prices Plan G on attained age but Plan A on issue age, meaning one carrier can use two rating methods simultaneously.
- UnitedHealthcare’s AARP Plan G is community-rated at a $423 base rate for males, but a 39% early-enrollment discount at age 65 drops the effective cost to roughly $258 — the discount, not the rating method, drives the early savings.
- Compare 20-year cumulative premium, not the age-65 quote; the cheapest starting rate is frequently the most expensive lifetime choice.
Two Maryland residents can buy identical Medigap Plan G coverage from two licensed carriers and, twenty years later, one will have paid tens of thousands more than the other. The benefits never differed. The rating method did.
CMS and the National Association of Insurance Commissioners jointly publish Choosing a Medigap Policy, which identifies three permitted pricing structures: community-rated, issue-age-rated, and attained-age-rated. That guide instructs shoppers to ask carriers directly which method applies — a question most applicants never ask, because agents rarely volunteer it.
This analysis uses filed rate data from the Maryland Insurance Administration, which publishes every carrier’s actual Plan A through Plan N premiums at ages 65, 70, 75, 80, and 85, alongside each carrier’s declared rating method. Washington National, Mutual of Omaha, UnitedHealthcare, Aetna, and Physicians Life all appear in that filing with materially different age curves. Below: what each method actually costs at five ages, where the crossover point falls, which carriers mix methods within a single product line, and how the Part B premium and IRMAA tiers stack on top of whatever you pay for supplemental coverage.
The Three Rating Methods, as CMS Defines Them
Federal guidance draws the distinction cleanly. Under community rating — also called no-age-rated — the carrier charges generally the same premium to everyone regardless of age or gender. Under issue-age rating, the premium is fixed by your age at purchase and does not rise because you get older. Under attained-age rating, the premium tracks your current age and climbs at each policy anniversary.
One nuance defeats most shoppers: all three methods permit rate increases. Inflation, claims experience, and benefit changes drive increases across every structure. What separates them is whether aging itself is an additional, independent driver. In attained-age policies it is. In the other two it is not.
CMS illustrates this with worked examples. A community-rated policy charges a 65-year-old and a 72-year-old the same $165 monthly premium. An issue-age policy charges the 65-year-old buyer $145 and the 72-year-old buyer $175 — different entry points, each frozen thereafter. An attained-age policy starts a 65-year-old at $120, moves to $126 at 66, and $132 at 67. CMS is explicit that these amounts are illustrations rather than market rates.
The agency’s own summary of attained-age pricing is unusually blunt for a government publication: premiums are low for younger buyers but they may be the least expensive at first and eventually become the most expensive. That sentence is the entire argument of this article, stated by the regulator.
What Filed 2026 Rates Actually Show
Illustrations are one thing. Filed rates are another. The table below draws Plan G premiums directly from the Maryland Insurance Administration’s July 2026 rate guide, using the male preferred or male non-tobacco class where available so the comparison holds constant.
Source: Maryland Insurance Administration, Medicare Supplement Monthly Premiums as of July 1, 2026. Plan G, male preferred or male non-tobacco class. UnitedHealthcare figures are base rates before the early-enrollment discount.
Read the far-right column carefully. Every carrier in the first four rows uses attained-age rating, yet the age slope ranges from 40% to 152%. Rating method establishes whether age drives your premium; the carrier’s filed rate schedule determines how steeply. Two attained-age policies are not equivalent risks.
Everence supplies the cleanest issue-age contrast in the filing — and note the asterisk buried in its own rate sheet: Everence Plan G is issue-age, but Everence Plan N is attained-age. Anyone weighing Plan G against Plan N on cost at this carrier is also, unknowingly, choosing between two different rating structures.
How the Community-Rated Discount Actually Works
UnitedHealthcare’s AARP-branded plans are the largest community-rated block in the Maryland filing, and they demonstrate why “community-rated equals flat” is too simple.
The filed base rate for Plan G is $423 monthly for a male non-tobacco applicant, unchanged at every age. But UnitedHealthcare layers an Early Enrollment Discount over that base: 39% for those enrolling within six months of their 65th birthday or Part B effective date, holding through age 68, then declining 3 percentage points per year — 36% at 69, 33% at 70 — until it reaches zero at 81.
Run the arithmetic. A 65-year-old enrolling on time pays roughly $258 monthly ($423 × 0.61). At 70 the discount has fallen to 33%, producing about $283. At 81 the discount is gone and the full $423 applies. That is a 64% rise from the effective age-65 rate to the age-81 rate — smaller than Washington National’s attained-age curve, but far from flat.
The carrier also files a Tier I Rate of $465 for Plan G, applied to applicants who enroll more than ten years after Medicare eligibility. Delaying enrollment carries a permanent 10% penalty at this carrier, independent of any federal late enrollment penalty you might also owe. Two separate penalties, two separate mechanisms, both triggered by the same delay.
Community rating removes age from the premium formula. It does not remove age from the pricing strategy.
Attained-Age vs Issue-Age: Which Is Better for a 65-Year-Old Enrolling On Time?
Model it with real filed rates. Compare Washington National’s attained-age Plan G against Everence’s issue-age Plan G, both male preferred or non-tobacco, both Maryland, both 2026.
Washington National charges $251 at 65, $324 at 70, $415 at 75, $519 at 80, and $633 at 85. Everence charges $269 at 65, $291 at 70, $310 at 75, $331 at 80, and $346 at 85.
Interpolating linearly between the published five-year checkpoints and summing monthly premiums across each interval, the attained-age policy costs approximately $103,800 over the twenty years from 65 to 85. The issue-age policy costs approximately $74,000. The gap is roughly $29,800 — and that is before compounding any general rate increases, which apply to both policies and would widen the absolute dollar difference further.
The crossover arrives fast. Washington National starts $18 per month cheaper. By 70 it is $33 per month more expensive. The attained-age policy repays its initial advantage inside the first three years, then spends seventeen years losing ground.
Verdict
For a 65-year-old enrolling during the six-month Medigap Open Enrollment Period with a normal life expectancy, issue-age rating wins decisively — roughly $29,800 cheaper across twenty years in this Maryland comparison, despite an $18-per-month higher starting premium. Attained-age rating is defensible only for someone who expects to switch carriers within three to five years, who is enrolling in their late seventies or eighties where the curves converge, or who lives in a state with an annual birthday rule permitting underwriting-free switches. Absent one of those conditions, the lower age-65 quote is a trap.
What Most People Get Wrong
Mistake 1: Comparing the age-65 quote and stopping there. Every broker quote sheet displays the current-age premium. Almost none display the age-85 premium, though carriers file it publicly. The consequence is systematic selection into steep attained-age curves. Correct action: request the carrier’s full filed rate schedule at 65, 70, 75, 80, and 85, or pull it from your state insurance department’s rate guide, which publishes exactly those checkpoints.
Mistake 2: Assuming a carrier uses one rating method across all products. Physicians Life prices Plan A on issue age and Plans F and G on attained age. Everence prices Plan G on issue age and Plan N on attained age. United American files as issue-age/attained-age. Choosing a plan letter can silently change your rating structure. Correct action: ask which method applies to the specific plan letter you are buying, not to the carrier generally.
Mistake 3: Treating community-rated as automatically cheapest. UnitedHealthcare’s $423 Plan G base rate exceeds every attained-age age-65 rate in the Maryland filing. Only the early-enrollment discount makes it competitive at 65, and that discount decays. Correct action: model the discount schedule explicitly rather than assuming flat means low.
Mistake 4: Ignoring the underwriting class shown on the rate sheet. Maryland’s guide publishes Preferred and Standard rates separately, and Standard rates cannot be used during Open Enrollment or a guaranteed issue period. Missing your enrollment window can move you from Washington National’s $251 preferred rate to its $279 standard rate at 65 — an 11% penalty that then compounds up the attained-age curve for life. Correct action: enroll during the six-month window when medical underwriting cannot apply.
Mistake 5: Budgeting the Medigap premium in isolation. A Plan G premium sits on top of the standard Part B premium of $202.90 monthly and the $283 annual Part B deductible, neither of which Plan G covers. A 65-year-old at Washington National’s rate is committing to $453.90 monthly in fixed 2026 healthcare costs before a single copay. Higher earners owe more still under the IRMAA surcharge rules.
Who Should Prioritize Rating Method — and Who Shouldn’t
Rating method matters most when the time horizon is long and switching is hard. Three profiles fall clearly on one side or the other.
Prioritize issue-age or community rating if: you are 65 to 70, in good health, expect to hold the policy for fifteen-plus years, and live in a state without an annual guaranteed-issue switching window. You will pay a modest premium now for a materially flatter curve later. This is the strongest case in the data.
Attained-age rating is defensible if: you live in a state with a birthday rule — Maryland grants policyholders a once-yearly open enrollment period covering their birthday and the following 30 days, allowing a switch to equal or lesser benefits without underwriting. Annual repricing power substantially neutralizes the attained-age penalty, because you can leave a steepening block. Roughly a dozen states have adopted some version of this; check your own state insurance department rather than assuming.
Rating method is secondary if: you are choosing between Medigap and Medicare Advantage in the first place. That decision involves network structure, prior authorization, and out-of-pocket caps, and it dwarfs the rating-method question. Work through the Medigap versus Advantage annual cost comparison first, and if you are managing an ongoing condition, the Advantage and Original Medicare comparison for chronic conditions before returning to carrier selection.
One structural warning applies across all three methods. Closed blocks — policy books no longer sold to new entrants — age into progressively sicker risk pools and file steeper increases. A community-rated policy inside a closed block can rise faster than an attained-age policy inside an actively marketed one. Ask whether the block is open before you sign.
What Changed for 2026
Three figures reset this year and they change the arithmetic on every comparison above.
The standard Part B premium rose to $202.90 monthly for 2026, an increase of $17.90 from $185.00 in 2025 — a 9.7% jump. CMS attributes the increase to projected price changes and utilization consistent with historical experience. The Part B deductible rose to $283 from $257.
The high-deductible option on Plans F and G carries a $2,950 threshold in 2026. You pay Medicare-covered coinsurance, copayments, and deductibles up to that amount before the policy pays anything, plus a separate $250 annual deductible for foreign travel emergency care. High-deductible Plan G rates in the Maryland filing run dramatically lower — Mutual of Omaha lists $61 monthly at 65 against $278 for standard Plan G — but the age curve behaves identically, since the same attained-age structure applies.
Plans K and L carry 2026 out-of-pocket limits of $8,000 and $4,000 respectively. After you meet that limit and the $283 Part B deductible, the plan pays 100% of covered services for the remainder of the calendar year. Neither figure interacts with rating method, but both belong in any total-cost model. If you are also weighing the Part A deductible and benefit period gaps, note that the Part A deductible resets per benefit period rather than annually — a distinction that materially changes exposure for anyone with repeat hospitalizations.
Frequently Asked Questions
Can I switch from an attained-age policy to an issue-age policy later?
Generally you have no federal right to switch Medigap policies outside your six-month Medigap Open Enrollment Period or a guaranteed issue situation, per CMS guidance. Some states add rights — Maryland’s birthday rule grants an annual 30-day window to switch to equal or lesser benefits without underwriting. Outside those windows, carriers may apply medical underwriting and deny you. Switching also restarts your issue age at your current age, so the locked-in rate reflects 75, not 65.
Which states require community-rated Medigap pricing?
Figure unavailable at publication — no single federal source publishes a current authoritative list, and secondary sources conflict, variously reporting eight or nine mandate states with recurring mentions of Arkansas, Connecticut, Maine, Massachusetts, Minnesota, New York, Vermont, and Washington. CMS directs consumers to their State Insurance Department for state-specific rules; the NAIC maintains the directory of those departments. Verify with your own state regulator before relying on any published list.
Does the rating method change what the plan covers?
No. CMS is explicit that all policies with the same letter offer identical basic benefits regardless of carrier, and that price is the only difference between same-letter policies. A Plan G covers the same Part A coinsurance, Part B coinsurance, and Part B excess charges whether it is community-rated at $423 or attained-age-rated at $251. Rating method affects only how the premium moves over time.
Do women pay less than men under every rating method?
Under attained-age and issue-age rating, most carriers file separate male and female schedules. Washington National’s Plan G runs $251 for a male preferred applicant at 65 and $226 for a female — about 10% less. Community rating as CMS defines it charges generally the same premium regardless of age or gender, though UnitedHealthcare’s Maryland filing still lists separate male and female base rates of $423 and $375 for Plan G.
How We Researched This Article
Premium figures come from a single primary source to preserve comparability: the Maryland Insurance Administration’s Medicare Supplement Monthly Premiums guide effective July 1, 2026. State insurance departments collect filed rates under statutory authority, which makes them the most reliable public record of what carriers actually charge. Maryland publishes premiums at ages 65, 70, 75, 80, and 85 for each plan letter, alongside each carrier’s declared rating method and underwriting class — a combination few states publish together. We extracted Plan G rates for the male preferred or male non-tobacco class across all carriers, then identified the declared rating method from each carrier’s header line.
Rating method definitions and the illustrative premium examples come from Choosing a Medigap Policy, CMS Product No. 02110, dated March 2026 and developed jointly by CMS and the NAIC. The 2026 Part B premium of $202.90 and deductible of $283 come from the CMS notice published in the Federal Register on November 19, 2025.
The twenty-year cumulative comparison is modeled, not measured. We interpolated linearly between published five-year rate checkpoints and summed monthly premiums from age 65 through 85. The model deliberately excludes general rate increases from inflation and claims experience, which apply to all three rating methods and cannot be forecast reliably; excluding them understates the absolute dollar gap between methods while preserving the direction and approximate magnitude. Actual cumulative cost will exceed both figures.
Three limitations bound these findings. Maryland’s rates do not transfer to other states — filings are state-specific, and Maryland’s birthday rule affects carrier pricing behavior in ways that may not hold elsewhere. Second, the analysis holds gender and underwriting class constant; tobacco status, household discounts ranging from 5% to 14% across carriers, and standard-versus-preferred classification all shift absolute premiums. Third, no authoritative federal list of state rating mandates exists, so we declined to publish a state count. Research conducted July 2026.
All figures were verified against named primary sources before publication.