Your Medigap Premium Went Up Again. Unlike Advantage, There’s No Annual Enrollment Window to Shop Without Health Questions.

A 72-year-old in Ohio opens a December rate notice and finds that her Medigap Plan G premium is rising again in January, the fourth increase in four years. Her broker finds a competitor charging $40 less each month.

Then come the health questions. Two medications and a recent cardiology visit lead to a decline. She can keep the Plan G she already owns, but the cheaper policy remains on the other side of an underwriting decision. That is the difference between Medigap and Medicare Advantage. Advantage members receive recurring opportunities to change plans without health questions. Medigap has no federal annual shopping window.

The Plan Letter Does Not Set the Price

Plan G tells a policyholder which standardized benefits the policy covers. It does not determine the premium or how that premium will change. Medigap insurers generally use one of three rating methods:

• Community-rated policies generally charge the same premium regardless of age to people holding the same policy. Prices can still vary because of location, tobacco use, household discounts and other permitted factors.
• Issue-age-rated policies base the starting premium on the buyer’s age when the policy is purchased. The price does not rise merely because the policyholder gets older, but it can increase because of inflation, claims experience and other factors.
• Attained-age-rated policies base the premium on the policyholder’s current age. The rate can rise as the person gets older and can also increase for the same broader reasons affecting other policies.

Those increases do not all happen in January. A new rate may begin on a policy anniversary, after a birthday or on another date allowed under the carrier’s state filing. The insurer’s rating method matters more than the month on the calendar.

Medicare Open Enrollment Does Not Open Medigap

Federal law provides one six-month Medigap Open Enrollment Period. It begins the first month a beneficiary is at least 65 and enrolled in Medicare Part B. During that period, an insurer must sell any Medigap policy it offers and cannot deny the applicant or charge more because of health. Once those six months end, the protection does not return every fall.

In most states, someone shopping later can face medical underwriting unless a federal guaranteed-issue right applies. A carrier may review diagnoses, recent treatment, medications and pending medical work before approving or declining the application. Federal law sets the floor, but state law can create additional paths. New York and Connecticut provide unusually broad access to Medigap without medical underwriting. Other states offer narrower birthday or anniversary rules, often allowing people who already own Medigap to switch to equal or lesser coverage. The exact protection depends on the state and the applicant’s current policy.

Advantage Has a Recurring Shopping Season

Medicare Advantage members can change coverage during Medicare Open Enrollment from October 15 through December 7. Someone already enrolled in Advantage receives another opportunity from January 1 through March 31, when one change is permitted. Neither period requires medical underwriting for the new Advantage plan. The member can switch plans or, depending on the period, return to Original Medicare.

Returning to Original Medicare does not necessarily guarantee a Medigap policy. Unless a trial right, plan termination or another protection applies, the supplement may still require underwriting. The Medicare change is easy. The Medigap approval beside it may not be. That is why the original decision between Advantage and Original Medicare with Medigap can become less reversible over time.

The Existing Policy Still Has Value

A rejected application does not cancel the Plan G already in force. Medigap policies are generally guaranteed renewable as long as premiums are paid and the policy was not obtained through fraud or material misrepresentation. The cost of the lock-in is a loss of shopping power. The policyholder can accept the higher premium, continue trying other carriers or consider a different Medicare structure during an available enrollment period. She should not drop the existing supplement while any replacement remains uncertain.

Without Medigap, Original Medicare has no annual out-of-pocket maximum. Plan G covers most Part A and Part B cost sharing after the annual Part B deductible. Medicare Advantage places a limit on covered spending but brings provider networks and plan rules into the tradeoff. Both paths also carry income-related premium consequences (we mapped IRMAA and the other quiet Medicare traps in a free guide here).

Shop Without Surrendering the Policy

Three moves can test the alternatives without giving up the coverage already in hand:

1. Ask the current insurer which rating method applies, when the increase takes effect and whether a household or payment discount is expiring. The state insurance department may also provide approved rate filings or complaint information.
2. Have a multi-carrier broker compare underwriting guides before submitting applications. If another carrier approves the application, wait for the written policy and confirmed effective date before canceling the current Plan G.
3. Price high-deductible Plan G if it is available. In 2026, the policy begins paying after the beneficiary incurs $2,950 in Medicare-covered cost sharing. Switching may still require underwriting, so compare the premium savings, deductible and approval rules together.

She may not be able to command a lower rate, but she can keep her current Plan G while testing every alternative. In Medigap, the policy already in hand is the bargaining chip she should never surrender first.

Contact [email protected] for any questions or corrections.