Medicare Supplement Cost Calculator
Compare Medigap supplement plan costs based on plan type, age, gender, region, and tobacco use with projected long-term costs.
Medicare Supplement Cost Calculator
Calculator
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Formula: Monthly Premium = Base Rate x Age Factor x Gender Factor x Region Factor x Tobacco Factor
Worked example — Monthly: $191 | Annual: $2,290 | 5-Year: ~$12,657
Formula
Monthly Premium = Base Rate x Age Factor x Gender Factor x Region Factor x Tobacco Factor
Medigap premiums are calculated starting from a base rate for each plan type, then adjusted for age (approximately 3% increase per year over 65), gender (males typically pay 8% more), geographic region (costs vary 10-20% by area), and tobacco use (15-25% surcharge for smokers). Long-term projections assume a 5% annual increase.
Worked Examples
Example 1: 67-Year-Old Female, Plan G, Midwest
Problem:A 67-year-old non-smoking woman in the Midwest wants Plan G coverage. Estimate monthly and annual costs.
Solution:Base premium Plan G: $200/month Age adjustment: 1 + (67-65) x 0.03 = 1.06 Gender adjustment: 1.0 (female) Region (Midwest): 0.90 Tobacco: 1.0 Monthly = $200 x 1.06 x 1.0 x 0.90 x 1.0 = $190.80 Annual = $190.80 x 12 = $2,290 5-year projected total (5% annual increase): ~$12,657
Result:Monthly: $191 | Annual: $2,290 | 5-Year: ~$12,657
Example 2: 70-Year-Old Male Smoker, Plan N, Northeast
Problem:A 70-year-old male smoker in the Northeast considers Plan N. Calculate estimated costs.
Solution:Base premium Plan N: $150/month Age adjustment: 1 + (70-65) x 0.03 = 1.15 Gender adjustment: 1.08 (male) Region (Northeast): 1.20 Tobacco surcharge: 1.20 Monthly = $150 x 1.15 x 1.08 x 1.20 x 1.20 = $267.93 Annual = $267.93 x 12 = $3,215 10-year total: ~$40,447
Result:Monthly: $268 | Annual: $3,215 | 10-Year: ~$40,447
Frequently Asked Questions
What is a Medicare Supplement (Medigap) plan?
A Medicare Supplement plan, commonly called Medigap, is private insurance that helps cover out-of-pocket costs not paid by Original Medicare Parts A and B. These costs include deductibles, copayments, and coinsurance. Medigap policies are standardized by the federal government and labeled with letters A through N, with each letter offering a specific set of benefits. All Plan G policies, for example, offer the same benefits regardless of which insurance company sells them, though premiums vary between insurers. Medigap policies work alongside Original Medicare, meaning Medicare pays its share first, then the Medigap policy pays some or all of the remaining costs. Unlike Medicare Advantage plans, Medigap policies do not include prescription drug coverage, so enrollees typically also need a standalone Part D plan.
Which Medigap plan offers the best value?
Plan G is widely considered the best overall value for Medicare Supplement coverage since Plan F became unavailable to new enrollees in 2020. Plan G covers everything Plan F did except the Part B deductible, which is approximately 240 dollars annually in 2024. Since Plan G premiums are typically 30 to 50 dollars less per month than Plan F was, enrollees save money even after paying the Part B deductible out of pocket. Plan N is another popular value option with lower premiums than Plan G, though it requires small copayments for some doctor visits and emergency room visits that do not result in admission. For those seeking the lowest premiums, Plans K and L offer cost-sharing arrangements with annual out-of-pocket maximums, providing some protection while keeping monthly costs lower.
How do Medigap premiums change over time?
Medigap premiums can be priced using three different methods, and understanding these methods is crucial for long-term cost planning. Community-rated (no-age-rated) plans charge the same premium regardless of age, meaning younger enrollees pay more initially but premiums increase only for inflation and claims experience. Issue-age-rated plans base premiums on your age at enrollment and do not increase due to aging, though general rate increases still apply. Attained-age-rated plans are the most common and start with the lowest premiums but increase as you age. Under attained-age pricing, premiums typically increase 3 to 5 percent annually due to age alone, plus additional increases for inflation and medical cost trends. Over a 20-year period, an attained-age plan can become significantly more expensive than a community-rated plan.
When is the best time to enroll in a Medigap plan?
The optimal time to enroll in a Medigap plan is during your Medigap Open Enrollment Period, which begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. This six-month window is critically important because during this period, insurance companies cannot deny you coverage, charge higher premiums based on health conditions, or impose waiting periods for pre-existing conditions. This is your guaranteed issue right. After the open enrollment period expires, insurance companies in most states can use medical underwriting to evaluate your health status and may deny coverage, exclude pre-existing conditions, or charge higher premiums. Some states offer additional protections, including guaranteed issue rights when switching plans. If you miss your initial enrollment period, your options become significantly more limited and potentially more expensive.
How does Medigap compare to Medicare Advantage?
Medigap and Medicare Advantage represent fundamentally different approaches to Medicare coverage and choosing between them is one of the most important healthcare decisions seniors make. Medigap works with Original Medicare, providing nationwide coverage with any provider who accepts Medicare, offering maximum flexibility and predictable costs but requiring separate Part D drug coverage and typically costing more in monthly premiums. Medicare Advantage replaces Original Medicare with managed care, often including drug coverage and extras like dental, vision, and hearing, with lower or zero premiums but restricted provider networks and potentially significant out-of-pocket costs for serious illness. Medigap is generally better for people who travel frequently, see many specialists, or want predictable costs. Medicare Advantage may suit those who want lower premiums and integrated benefits and are comfortable using network providers.
If the benefits are standardised, why do insurers charge different premiums for the same plan letter?
Federal standardisation fixes what a plan letter pays, not what it costs. Insurers differ in the rating method they use, the claims experience of the block of policyholders they have accumulated, their expense loads and commissions, and the discounts they offer. A block that stops accepting new entrants ages and gets sicker, so its rate increases accelerate even though the benefits never change. Comparing the same letter across several carriers, and asking about that carrier's recent increase history, matters as much as the opening premium.
What does a Medigap policy not cover?
Medigap fills the cost-sharing gaps in Original Medicare, so it only pays where Medicare pays. It does not provide outpatient prescription drug coverage, which is why a separate Part D plan is normally needed, and it does not cover routine dental, vision or hearing care, eyeglasses or hearing aids. It also does not fund long-term custodial care in a nursing home or assisted living, or private duty nursing. Each policy covers one person, so a married couple needs two policies and two premiums.
Can I switch Medigap plans or insurers after I enrol?
You may apply at any time, but outside a guaranteed-issue situation most states allow the new insurer to underwrite your health, so a switch is easy while healthy and can be refused once it is not. A handful of states run birthday or anniversary rules that let existing policyholders move to an equal or lesser plan without underwriting for a set period each year. New policies also carry a free-look window during which you can cancel for a refund. Keep the old policy in force until the new one is confirmed.
Why do age, gender and tobacco use change a Medigap quote when Medicare itself ignores them?
Medigap is private insurance priced on expected claims, unlike Medicare premiums which are set federally and, above the income surcharge, ignore health. Older applicants generate more claims, smokers more still, and observed utilisation differs by sex, so carriers load the base rate accordingly. What they are permitted to use varies: some states mandate community rating, which bans age-based pricing entirely, and some restrict gender rating. Treat the multipliers in this estimate as typical industry practice rather than a universal rule.
Does a Medigap plan cover medical care outside the United States?
Original Medicare pays for almost no care outside the country, so foreign travel is a genuine gap. Several of the standardised plan letters include a foreign travel emergency benefit that pays a share of the cost of emergency care beginning during the early part of a trip, after a separate deductible and subject to a lifetime maximum. It applies to emergencies only, not planned treatment, and the lifetime cap is modest against a serious hospitalisation. Frequent travellers usually add a dedicated travel medical policy.
References
Reviewed for accuracy by Daniel Agrici, Founder & Lead Developer · Editorial policy
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