Attained Age vs Issue Age Medigap Plans

If you’re comparing Medicare Supplement (Medigap) plans, one thing that might not be immediately obvious – but can have a big financial impact – is how your age affects your premiums.

Specifically, Medigap plans can be priced based on attained age, issue age, or community rating. In this guide, we’ll focus on the two most common: attained age and issue age.

At first glance, you might be tempted to pick the plan with the lowest monthly premium. And who wouldn’t? But beneath the surface, how your age is factored into your premium can have a lasting effect that becomes more noticeable with each passing year.

Picture this: You’re 65, newly enrolled in Medicare, and feeling pretty healthy. You choose a low-cost Medigap plan, thinking you’ve scored a great deal.

But a few years down the road, you notice your premiums are creeping up – not just a little, but noticeably – and now that you’ve developed some health issues, switching plans is either expensive or impossible.

What happened? The likely culprit is attained age pricing.

This guide explains the differences between attained-age and issue-age Medigap plans, showing how each works, what to expect in future costs, and which might be better suited to your needs depending on your health, age, and long-term financial goals.

You’ll also see side-by-side comparisons, real-world scenarios, and practical advice to help you make an informed, confident decision – not just for today, but for the years ahead.

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What Are Attained-Age Medigap Plans?

An attained age-rated Medigap plan is the most common pricing model used across the country.

Here’s how it works: When you first enroll, your premium is based on your current age, usually around age 65. But as the years go by and your birthday candles multiply, so does your premium.

For example:

• At age 65, you might pay $110/month for Plan G.
• By age 70, that could rise to $135/month.
• By age 75, you’re paying $160/month.
• And by age 80, perhaps $190/month or more.

These increases can be gradual or sharp, depending on the insurer’s pricing practices. And remember – this is in addition to annual cost-of-living adjustments or inflation-based increases, which apply to all plans regardless of rating type.

Attained age pricing can feel like a good deal early on, especially for healthy, cost-conscious retirees. But over time, it can quietly turn into a budget strain, especially for those on fixed incomes.

Do All States Offer Attained-Age-Rated Medigap Plans?

No, attained-age-rated Medigap plans are not available in every state, though they are the default pricing method in the majority of them.

In most states, Medigap insurers are allowed to price plans based on the enrollee’s current age. This means your premium will start lower at age 65 and gradually increase as you get older. It’s popular because it gives insurers more flexibility and allows them to offer initially attractive premiums.

However, there are notable exceptions. Several states prohibit attained-age pricing and instead require alternative models, such as issue-age or community-rated pricing:

• New York – Community-rated only
• Connecticut – Community-rated only
• Massachusetts – Uses a modified Medigap structure; premiums are community-rated
• Arkansas – Requires issue-age pricing
• Maine – Community-rated or issue-age only

In these states, insurers cannot raise your premiums just because you’re getting older. That’s a huge win for people who want long-term stability and predictability in their healthcare budget.

So, who offers attained-age-rated Medigap plans? In short, almost everyone, unless your state says otherwise.

Cigna, for example, often enters markets with highly competitive Plan N or High Deductible Plan G rates based on attained age. This makes their plans attractive to first-time enrollees who want strong benefits without paying top-tier premiums. But over time, the rates climb, not just due to inflation, but because you’re aging.

Similarly, Mutual of Omaha is widely available and often praised for its customer service and financial stability. However, most of its Medigap offerings are priced using the attained-age model. The company does provide detailed rate increase histories. It is generally transparent about how premiums will change over time, but it’s still essential to ask for future projections, especially if you plan to keep the policy for life.

UnitedHealthcare, which underwrites Medigap plans endorsed by AARP, also uses attained-age pricing in many of its markets. UnitedHealthcare often promotes low entry premiums in states that allow it and adds value through wellness programs and member discounts. But again, as the insured population ages, the monthly cost increases, not just due to inflation or claims usage, but as a direct result of the attained-age pricing model.

Even Blue Cross Blue Shield affiliates – operating under names like Anthem, Florida Blue, or BCBS of Texas – tend to default to attained-age pricing unless state regulations require something else. These regional providers typically follow the pricing norms of their local markets, and in most states, that means increasing your premiums gradually as you grow older.

Now, if you live in states like Connecticut, New York, or Massachusetts, you won’t encounter attained-age pricing at all. These states require community rating, which prohibits insurers from raising premiums based on age. But outside of these few exceptions, attained-age pricing is the national norm.

What Are Issue-Age Medigap Plans?

Issue age-rated Medigap plans take a different approach. Your premium is based on your age when you first enroll, and it stays tied to that age forever.

This means that individuals who enroll in an issue-age plan at a younger age may be able to secure lower premiums for the lifetime of their policy. It is important to note that issue-age policies may initially have lower monthly premiums but may still increase over time, as with any Medigap policy.

So if you sign up at 65, and your monthly rate is $125, that rate will never increase simply because you’re aging. The only premium changes will be due to:

• Inflation
• Company-wide rate adjustments
• Regulatory or market shifts

Real-Life Scenario

Now that we’ve walked through the basics of both issue age and attained age pricing, let’s run a real-world comparison of two people, Mary and Charles.

Mary chose an attained age Plan G at 65.
Charles chose an issue age Plan G at the same age.

Here’s how their costs might look over the next 15 years:

Age	Mary (Attained Age)	Charles (Issue Age)
65	$110/month	$125/month
70	$135/month	$125/month
75	$160/month	$125/month
80	$190/month	$125/month
Total over 15 years	$28,800	$22,500

At first, Mary saves $15/month. But by age 75, Charles is paying $35/month less, and by 80, he’s saving $65/month. Over time, those differences add up to thousands of dollars.

That’s why many financial planners recommend that if you can afford an issue age plan’s slightly higher upfront premium, it’s often the better long-term investment.

Key Differences at a Glance

Feature	Attained Age Plan	Issue Age Plan
Initial Premium	Usually lower	Typically higher
Premiums Increase With Age?	Yes	No
Inflation-Based Increases?	Yes	Yes
Long-Term Cost Stability	Less predictable	More predictable
Common in States Like	FL, TX, IL	AZ, AR, GA (varies by insurer)

Do All States Offer Issue-Age-Rated Medigap Plans?

No, issue age-rated Medigap plans are not universally available across all states. In most of the country, insurers use attained age pricing as their default model because it starts premiums low and allows for gradual increases over time.

However, some states either require, encourage, or have insurers that choose to offer issue age pricing instead. These states include:

• Arizona
• Florida
• Georgia
• Idaho
• Arkansas
• Missouri

In these states, more insurers offer issue-age-rated plans, although not necessarily for every Medigap letter (e.g., Plan G or Plan N).

Other states, like New York and Connecticut, go even further and mandate community rating, which charges the same base premium to everyone regardless of age.

If you live in a state where issue-age-rated plans aren’t available, you won’t have the option to enroll in a plan that locks in your premium based on your age at the time of enrollment. Instead, your choices may be limited to attained-age or community-rated plans.

So, who actually offers issue-age-rated Medigap plans?

One of the more reliable providers in this category is Aetna. Known for its broad availability and strong brand recognition, Aetna offers issue-age pricing in certain states like Florida and Arizona.

In those states, beneficiaries can enroll in popular plans like Plan G or Plan N and rest easy knowing their premiums won’t increase simply because they get older. Aetna’s issue-age plans are often paired with add-on dental and vision bundles, and they offer a modest household discount in many regions.

Then you have the Blue Cross Blue Shield (BCBS) affiliates. These operate independently in each state, which means their pricing model varies. For example, Florida Blue offers issue-age-rated plans, whereas another state’s BCBS might lean entirely on attained-age pricing. The key with BCBS is to check your local affiliate’s Medigap offering directly – what’s true in Georgia won’t necessarily apply in Michigan or Pennsylvania.

Aflac is a newer entrant into the Medicare Supplement space, but in the states where it’s been approved to operate – like Georgia and parts of the Southeast – it has rolled out issue-age plans using Aetna’s backend systems. The setup is streamlined, the customer support is 24/7, and Aflac’s plans tend to appeal to cost-conscious seniors who still want predictability as they age.

Even Mutual of Omaha, one of the most trusted Medigap carriers, occasionally offers issue-age pricing, although it’s more commonly associated with attained-age structures. In certain states, particularly those with more consumer-friendly regulations like Arkansas, Mutual of Omaha may price policies based on your age when you first enroll, offering that long-term premium stability many retirees find comforting.

But here’s what’s important: these offerings are highly localized. An insurer may offer issue-age pricing in Phoenix but not in Denver or Tampa. That’s why asking what plan letters are available when shopping for a Medigap policy is not enough.

You need to ask the follow-up question: “How is this plan priced in my ZIP code?” The same Plan G from two different insurers – or even the same insurer in different counties – could be based on completely different pricing models.

In general, states like Florida, Arizona, Georgia, Idaho, Missouri, and Arkansas are more likely to feature issue-age pricing. If you live outside these areas, your chances of finding such a plan drop, but it’s still worth checking, especially if you’re enrolling at a younger Medicare age and want to lock in a stable premium before rates start climbing.

Practical Advice: Which One Should You Choose?

There is no universal “right” choice – it depends on your financial situation, health outlook, and risk tolerance.

But here are some things to consider:

Choose Attained Age if:

• You’re focused on minimizing short-term costs
• You’re in excellent health and don’t anticipate frequent care
• You’re okay with possibly switching plans later (while still insurable)

Choose Issue Age if:

• You value predictability and want to avoid rising premiums as you age
• You have chronic conditions and want to lock in a stable rate
• You plan to keep your Medigap plan for life and don’t want to gamble on future underwriting

Bonus tip: Some insurers offer both pricing models, so if you’re not sure which to choose, ask your licensed Medicare advisor to run comparisons at multiple ages and across a 10–15-year forecast. A few extra dollars now could save you much more later.

What About Community-Rated Medigap Plans?

You’ve heard about attained age and issue age pricing, but a third option is worth understanding: the community-rated Medigap plan.

Unlike plans that base your premium on your age, community-rated plans charge the same base premium to everyone in a given area, regardless of age. Whether you’re 65 or 85, your starting rate is the same as your neighbor’s – at least in theory.

Community-rated (sometimes called “no-age-rated”) pricing is exactly what it sounds like: the entire community pays the same rate for the same plan.

In other words:

• A 65-year-old pays the same as a 75-year-old for Plan G in that ZIP code.
• The price does not increase because you’re aging.
• It can still increase due to inflation or company-wide rate adjustments, but not just because of your birthday.

Let’s look at an example:

Susan (65) and Dolores (75) both enroll in a community-rated Plan N in their area.The insurer charges $145/month for everyone enrolled in that plan.

Five years later, the premium has increased to $158/month due to inflation – but again, everyone pays the same, regardless of age.

Here’s a comparison of the community-rated plans compared to both issue age and attained age.

Feature	Community-Rated	Attained Age	Issue Age
Age Affects Premium?	No	Yes	Only at enrollment
Initial Premium	Mid-range	Typically lowest	Slightly higher
Premiums Increase with Age?	No	Yes	No
Available Nationwide?	Limited	Widespread	Moderate

Note: Community-rated plans are most common in states that encourage or mandate this pricing model, such as:

• New York
• Connecticut
• Vermont
• Massachusetts (offers alternative Medigap models)

In these states, insurers often have less flexibility in pricing based on age or health history, making Medigap more accessible to older or higher-risk individuals.

Factors to Consider When Choosing a Medigap Plan

When selecting a Medigap plan, there are several important aspects to consider. Understanding the factors to consider when choosing a Medigap plan is crucial to ensure you make an informed decision regarding your healthcare coverage.

Here are five key points to consider:

#1. Coverage Options: Evaluate the Medigap plans and assess which best aligns with your healthcare needs. Consider the coverage for hospital stays, skilled nursing care, and hospice care.

#2. Cost: Determine the financial implications of each Medigap plan, including premiums, deductibles, and out-of-pocket costs. Compare the costs associated with each Medigap plan to find the best value for your situation.

#3. Network Restrictions: Unlike Medicare Advantage plans, Medigap plans do not have specific networks of doctors or hospitals. This means you can visit any healthcare provider that accepts Medicare patients. If you prefer the freedom to choose any provider, a Medigap plan may be right for you.

#4. Guaranteed Issue Rights: Understand your guaranteed issue rights, which allow you to enroll in a Medigap plan without being denied coverage or charged higher premiums due to pre-existing conditions. It’s important to know when these rights apply to ensure you can secure the coverage you need.

#5. Attained-Age vs. Issue-Age: Consider whether you prefer a Medigap plan based on attained-age or issue-age. This distinction refers to how premiums increase over time. Attained-age plans have premiums that increase with your age, while Issue-age plans have premiums based on your age at the time of enrollment.

Final Thoughts: Think Long-Term, Not Just Monthly

At the end of the day, understanding the difference between attained-age and issue-age pricing isn’t just a detail – it’s a strategy. While the benefits of Medigap plans themselves are standardized, how much you’ll pay over time can vary drastically depending on which pricing model your plan follows.

Attained-age pricing might lure you in with lower premiums at age 65, but it comes with the quiet reality of increasing costs as the years go on. Issue-age pricing, on the other hand, asks you to invest a little more upfront for the peace of mind that your age won’t become a financial liability later.

The choice between them is deeply personal. If you’re on a fixed income, have chronic health concerns, or plan to keep your Medigap policy for life, locking in an issue-age plan early could shield you from future rate hikes that may otherwise force difficult trade-offs.

But if you’re in great health, budget-conscious, and open to switching plans later, while you’re still insurable, attained-age plans might provide just the right balance of coverage and cost.

No matter which path you choose, the most important thing is that you’re asking the right questions now. Understanding how your premiums will behave over time puts you in control – not just of your coverage, but of your financial future. And that’s what smart Medicare planning is all about.

FAQs

• Why do insurers prefer attained age pricing?

  Attained age plans often look cheaper to new enrollees, which makes them easier to sell. They allow insurers to start premiums low and increase them steadily, often leading to higher profits over time. In contrast, issue age plans offer more stability to the consumer, which can be more challenging for insurers to manage financially.

• Do all states allow both pricing types?

  No. Availability depends on your state and insurer. Some states (like Florida and Texas) primarily use attained age pricing, while others (like Arizona or Georgia) may offer both. Always ask your insurer what pricing model applies – just knowing the plan letter (e.g., Plan G) isn’t enough to understand your costs.

• Are community-rated premiums really the same for everyone, or are there exceptions?

  In principle, community-rated plans charge the same base premium to all policyholders in a specific geographic area, regardless of age. However, insurers can still adjust rates based on other factors, such as:

  • Smoking status
  • ZIP code or region
  • Household discounts

  So while age doesn’t increase your premium, your lifestyle or location might.

• If I enroll in a community-rated plan at 65, will I pay more than someone in an attained-age plan?

  Most likely, yes – at first. Community-rated plans often have higher starting premiums than attained-age plans because they’re not “discounting” your rate based on youth. But over time, attained-age premiums rise with age, while community-rated plans stay more stable. The result? Community-rated plans often become the better value around age 75 and beyond.

• If I move from a community-rated state to an attained-age state, will my pricing change?

  It depends. If you keep your original Medigap policy, your premium will likely continue under the original pricing structure, even if you relocate. However, if you switch plans or insurers after moving, you’ll be subject to the new state’s available plans and pricing models, which may include medical underwriting or higher premiums based on your age.

• If community-rated plans are more stable, why don’t more insurers offer them?

  Community-rated pricing is often mandated or encouraged in certain states, but in others, it’s less profitable for insurers, especially if most of their enrollees are younger and healthier. Attained age pricing allows insurers to start people off low and raise rates steadily, which can seem more competitive on paper. As a result, community-rated plans are less common, but not necessarily less effective.