The three ways companies price Medigap
| Method | How it works | What it means for you |
|---|---|---|
| Community-rated ("no-age-rated") | Generally the same premium for everyone, regardless of age | Your age doesn't raise your premium; other factors can |
| Issue-age-rated ("entry-age-rated") | Based on your age when you buy | Lower if you buy younger; doesn't rise because you age |
| Attained-age-rated | Based on your current age | Low at first, then rises as you get older |
Because the benefits of a plan letter are the same from every company, price and pricing method are the main differences between two Plan G policies.
What North Carolina law adds
- Attained-age disclosure: G.S. 58-54-25(f) bars attained-age pricing unless it is fully disclosed when you apply. All solicitation materials must say premiums are based on attained age, "which means that those premiums will increase each year." The notice must include an illustration of your premium increases over at least 10 policy years, and a statement that issue-age policies "do not increase as the insured ages" and should be compared.
- Annual rate filings: every company must file its rates and rating schedules with the state each year to show it meets North Carolina's loss-ratio standards, which require benefits that are reasonable in relation to the premium (G.S. 58-54-20(b)).
- Under 65: companies may set separate rates for people under 65 with a disability, filed with and approved by the Commissioner of Insurance (G.S. 58-54-45(c)).
- Health: during your open enrollment, a company can't charge you more because of your health. Outside it, without a guaranteed-issue right, it can.
Why it matters more in North Carolina
North Carolina has no birthday rule. If your premium climbs later, moving to a cheaper policy usually means answering health questions, and you could be turned down. So the policy you pick at 65 may be the one you keep. That makes the pricing method, and the company's rate history, worth asking about before you buy.
- Ask how the policy is priced. Community, issue-age or attained-age.
- For attained-age policies, read the 10-year illustration. North Carolina requires it.
- Ask how rates have changed over the last few years.
- Compare the same plan letter across several companies.
To compare Medigap policies from the companies they work with, you can request a call from a licensed insurance agent. More in Medigap in North Carolina.
Related questions
Medigap Plan G vs. Plan N
Same core benefits, different trade-offs.
Can I switch Medigap plans in North Carolina?
What to do if your premium rises.
Does North Carolina have a Medigap birthday rule?
No; why that matters.
Sources
- N.C. General Assembly — G.S. 58-54-25, Disclosure standards
- N.C. General Assembly — G.S. 58-54-20, Loss ratio standards and filing requirements
- N.C. General Assembly — G.S. 58-54-45, By reason of disability
- Medicare.gov — Get Medigap costs
- CMS — Choosing a Medigap Policy (how companies set prices)
More questions in this guide
- Can I get Medigap under 65 in North Carolina?
- Can I get a Medicare Supplement with pre-existing conditions in North Carolina?
- Can I switch Medigap plans in North Carolina?
- Does North Carolina have a Medigap birthday rule?
- Medigap Plan G vs. Plan N in North Carolina
- What happens to my Medigap if I move out of North Carolina?
- When can I buy a Medicare Supplement plan in North Carolina?
Part of the guide: Medigap (Medicare Supplement) in North Carolina · All questions
Frequently asked questions
Which pricing method is cheapest?
None is always cheapest. Attained-age policies often cost less at 65 but rise as you age, and CMS notes they can eventually become the most expensive. Compare both today's premium and how it is likely to change.
Can my Medigap premium go up even if it isn't age-rated?
Yes. Community-rated and issue-age-rated premiums can still rise because of inflation and other factors, just not because you got older.
Do companies in North Carolina offer discounts?
Some do. CMS lists discounts some companies offer, such as for non-smokers, women, married people, paying yearly or paying by electronic funds transfer. Ask each company what it offers.
Medicare in your North Carolina county
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