By Mike Miligi, Certified Medicare Insurance Planner- Michael M Insurance Services
Medigap bills have jumped sharply for 2026. Here’s what’s driving it, why guarantee-issue states are
feeling it hardest, and the alternatives worth a real look — including one plan most people have never
considered
If your Medicare Supplement renewal notice landed with a bigger number than you expected this year,
you’re not imagining it, and you’re not alone. Across the country, Medigap carriers have been filing some
of the steepest rate increases seen in years — in many cases well into double digits, and in a handful of
markets even higher. This isn’t a billing error or a fluke with your specific carrier. It’s a broader shift in the
Medigap market, and understanding why it’s happening puts you in a much better position to respond.
$202.90*
Standard Medicare Part B premium
for 2026, up from $185 — every
dollar of it flows straight into Medigap
claims costs.
$38.99*
2026 Part D base beneficiary
premium, a 6% increase — the
maximum allowed under current law.
$2,950*
2026 deductible for High Deductible
Plan G, a lower-premium alternative
worth a closer look this year.
*All three figures are 2026 amounts and are expected to increase again for 2027 — CMS typically announces updated Part B, Part D, and
Medigap deductible amounts in the fall.
Why Medigap Premiums Are Rising So Fast
A few forces are hitting the Medigap market at the same time, and they compound rather than cancel out:
Rising Part B costs flow straight through
Medigap plans exist to cover what Original Medicare doesn’t — largely the 20% coinsurance on Part B services.
When the Part B premium and deductible rise, as they did again for 2026, the underlying medical costs
Medigap is on the hook for rise too. Higher claims costs eventually show up as higher premiums, because
Medigap carriers are required to price to their actual claims experience.
An aging, shrinking risk pool
Plans C and F closed to anyone newly eligible for Medicare starting in 2020. That means the pool of people
holding those older, richer plans only gets older each year — no new, generally healthier 65-year-olds are
coming in behind them to balance the risk. Plan G has absorbed most new enrollment since then, but even Plan
G pools are maturing, and insurers price accordingly
Medical inflation and higher utilization
Healthcare prices and the volume of services used per person have both been climbing steadily. More visits,
more outpatient procedures, more imaging — all of it lands as claims on the Medigap side, and claims trend is
the single biggest input into next year’s rate filing
Why guarantee-issue and community-rated states feel it hardest
In states with year-round guaranteed issue or full community rating, insurers can’t turn applicants away
or charge more based on health, and in community-rated states, they generally can’t charge more based
on age either — everyone in a given plan pays close to the same rate regardless of when they enrolled.
That’s real consumer protection, and it matters. But it also means the entire pool absorbs rising claims
costs together, without the offsetting effect that fresh, lower-utilization 65-year-olds provide in age-rated
states. When claims trend up in a community-rated, guarantee-issue market, the increase tends to show
up faster and larger across the whole book of business. If you’re in one of these states, it’s worth
understanding your state’s specific rating method — it explains a lot about why the increase looked the
way it did.
It's Not Just Medigap — Part D Is Climbing Too
It’s easy to look at a Medigap renewal in isolation, but for most people the real number that matters is the total
monthly cost of coverage: Part B, Medigap, and a Part D drug plan (or the drug coverage bundled into Medicare
Advantage) all together. And Part D has its own cost pressure right now. The national base beneficiary premium
for 2026 rose to $38.99, a 6% increase — the maximum allowed under current federal rules — while the
standard Part D deductible rose as well. Insurers’ actual bids for drug coverage moved up even more sharply
behind the scenes, largely driven by the rising cost of prescription drugs.
The practical effect: even if your specific Medigap increase looks moderate, a same-year jump in your Part D
premium can push your combined monthly outlay up considerably more than either number suggests on its
own.
Part B premium
Standard 2026 amount
$202.90
Medigap premium
Illustrative example — yours will vary by plan, carrier, and state
$175
Part D premium
Illustrative example — plan-specific
$45
Total monthly cost of coverage
$422.90
The Medigap and Part D figures above are illustrative only, to show how the pieces stack — not a quote. Your actual numbers depend on your
plan, carrier, ZIP code, and current rates.
Viable Alternatives Worth Considering
Shop the same plan letter with a different carrier
Because Medigap benefits are standardized by federal law, a Plan G from one carrier covers exactly the same
things as a Plan G from another — price is the only real variable. If your current carrier’s increase was steep, a
competitor may offer the identical benefit for meaningfully less. Switching carriers for the same or lesser plan
usually requires medical underwriting outside your original enrollment window, though a number of states
have a “birthday rule” or similar provision allowing an annual switch without health questions — worth
checking for your specific state.
Consider High Deductible Plan G
This is one of the most underused options on the table. High Deductible Plan G provides the exact same
coverage as standard Plan G — it just doesn’t kick in until you’ve paid $2,950 in Medicare-approved cost
sharing for the year (2026 amount). Medicare still pays its share from day one; you’re simply responsible for
more of the remaining 20% upfront. In exchange, the monthly premium is substantially lower — often low
enough that even a year with real medical use still comes out ahead of standard Plan G’s higher premium. For
someone in reasonably good health who mainly wants protection against a catastrophic year rather than first
dollar coverage, it’s worth running the actual numbers.
Downgrade to Plan N
Plan N carries a noticeably lower premium than Plan G in most markets, in exchange for small fixed copays (up
to $20 for some office visits, up to $50 for an ER visit that doesn’t result in admission) and responsibility for any
Part B excess charges. For people who don’t expect frequent specialist visits, the premium savings can
outweigh the modest copays.
Take a serious look at Medicare Advantage
Medicare Advantage plans bundle Part B, typically Part D, and often dental, vision, and hearing benefits,
frequently for a low or $0 monthly premium, with a built-in annual out-of-pocket maximum that Original
Medicare alone doesn’t have. That structure can be a meaningfully cheaper path for people who are cost
sensitive and comfortable with a plan network, referrals, and prior authorization requirements. It’s a real trade
off, not a strict upgrade or downgrade from Medigap — flexibility and no networks on one side, lower monthly
cost and capped exposure on the other.
Think carefully before giving up Medigap for Medicare Advantage
Moving from a Medigap plan into Medicare Advantage is usually easy to do. Moving back is often not. If
you drop your Medigap policy and later decide Medicare Advantage isn’t the right fit, getting back into a
Medigap plan may require answering health questions in most states — and if your health has changed,
you could be charged more or turned down entirely. A small number of situations, like a Trial Right period
for first-time Medicare Advantage enrollees, provide protection for exactly this scenario. This is one of the
more consequential decisions in this whole discussion, and it’s worth a real conversation before acting
rather than a decision made from a renewal notice alone.
Prioritize flexibility and stable coverage
Staying in Medigap — potentially shopping
carriers or moving to HD Plan G or Plan N —
keeps you free of networks and referrals.
Prioritize lower monthly cost
Medicare Advantage may meaningfully reduce
your monthly outlay, in exchange for a network
and plan rules to work within.
What To Actually Do About This Year's Increase
- Look at your total cost, not just the Medigap line. Add Part B, your Medigap premium, and your Part D premium together before deciding how big the increase really is.
- Get quotes for your exact plan letter from other carriers. Same benefits, different price — this is often the single easiest fix.
- Run the numbers on High Deductible Plan G. Even a moderate-use year can come out ahead once you compare the premium savings to the deductible exposure.
- Check whether your state has a birthday rule or similar switching provision. It may let you shop without medical underwriting.
- Compare Medicare Advantage honestly, not just on price. Look at the network, prior authorization requirements, and your own providers before assuming it's an easy swap.
Quick Questions, Straight Answers
Why did my Medigap premium go up so much this year?
A combination of rising Part B costs, medical inflation, higher utilization, and an aging risk pool (since Plans C and F
stopped accepting new enrollees in 2020) is pushing claims costs up across the industry — and premiums follow
claims costs.
I've never filed a claim. Why did my rate still go up?
Medigap premiums are priced based on the entire risk pool’s claims experience, not your individual claims history.
Your rate reflects what everyone in your plan and rating group is costing the insurer collectively.
What's the difference between community rating and attained-age rating, and why does it matter?
Community-rated plans charge the same premium to everyone regardless of age; attained-age plans increase your
premium as you get older. Community rating spreads cost more evenly but means the whole pool — not just older
members — absorbs rising claims together, which can make increases land harder and faster.
Can I switch to a cheaper carrier for the same Plan G coverage?
Yes — since Medigap benefits are standardized by plan letter, a Plan G is a Plan G no matter who sells it. Comparing
carrier pricing for your exact plan letter is one of the most effective ways to lower your bill without giving up any
coverage.
Will switching carriers require medical underwriting?
In most states, yes, outside your original Medigap enrollment window or a qualifying event. Some states offer a
birthday rule or similar annual window that allows a switch to equal or lesser coverage without health questions —
this varies by state.
What is a "birthday rule" state?
It’s a state provision that gives you a window — often around your birthday — to switch to a different Medigap
carrier offering equal or lesser benefits, without answering health questions. Not all states have this rule, so it’s
worth confirming for your own state.
Is High Deductible Plan G a good idea for me?
It tends to work well for people in reasonably good health who want protection against a catastrophic year rather
than first-dollar coverage on every visit. The lower premium can outpace the deductible exposure even in years with
meaningful medical use — it’s worth running your specific numbers.
How much could I actually save by moving to HD Plan G?
It depends entirely on your current premium and how much medical care you typically use in a year — there’s no
single answer that applies to everyone. A side-by-side comparison using your actual current premium against HD
Plan G’s premium and $2,950 deductible (2026 amount) is the only way to know for sure.
Should I just switch to Medicare Advantage to save money?
It can meaningfully lower your monthly cost, but it’s a real trade-off — you take on a plan network, referrals, and
prior authorization requirements in exchange. It’s worth comparing honestly against your own providers and health
needs rather than deciding on price alone.
If I switch to Medicare Advantage, can I get my Medigap plan back later?
Not automatically. Outside specific protections like a Trial Right period for first-time Medicare Advantage enrollees,
returning to Medigap in most states means going through medical underwriting again — so this decision deserves
real thought before you act, not just a reaction to this year’s bill.
Watching your Medigap premium climb year after year is frustrating, and it’s not something you have to just
accept without a second look. Whether the right move is shopping carriers, switching to High Deductible Plan
G, or seriously comparing Medicare Advantage depends entirely on your health, your budget, and how much
you value flexibility over a lower monthly bill. I’ve spent over 10 years helping people work through exactly
this decision, and I’m a Medicare beneficiary myself, so I understand the stakes firsthand. If you’d like help
running your specific numbers in Babylon, give me a call. That conversation is always free.
Mike Miligi
Owner, Michael M Insurance Service
For over 10 years, Mike has helped seniors and other Medicare-eligible individuals understand their options, including
Medicare Advantage Plans (Part C), Medicare Supplement Plans (Medigap), Prescription Drug Plans (Part D), and dental
and vision programs. Mike is licensed in seven states and certified with 11 insurance carriers. As an independent
Medicare health insurance broker, he works for the client, not the insurance carriers, providing accurate, unbiased
options. Mike recertifies with CMS annually and completes continuing education to stay current on industry standards.
(631) 774-3786 | mmilinsurance@gmail.com | www.mymedicaremike.com
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