Attained-Age, Issue-Age, and Community-Rated are three different ways you pay for your Medicare Supplement Plans (Medigap).
Attained-Age costs are typically based on your age and increase as you grow older. Issue-Age costs are usually based on the age you were when you signed up and increase based only on other factors, like inflation.
Community-Rated costs, also called no-age-rated costs, typically use a base premium that isn’t determined by age, though they can still rise because of inflation and other factors.
When signing up for any Medigap plan, it’s important to check whether the plan uses Attained-Age, Issue-Age, or Community-Rated pricing, as this may affect the cost over your lifetime.
In this post, we’ll explain the differences between these three pricing methods and help you decide which works best for you.
What is Medigap?
Before we get into whether you should choose Attained-Age, Issue-Age, or Community-Rated pricing, we need to define Medigap.
Medigap, which is another name for Medicare Supplement Plans, helps pay some of your share of the costs for services covered by Original Medicare, including certain deductibles, copayments, and coinsurance.
This coverage is provided by insurance companies and you can choose from a variety of plans.
Three Ways Medigap Plans Are Priced
Issue-Age Medigap Plans
The main thing you need to know about Issue-Age rates is that your monthly cost will be based on your age when you sign up, and it won’t increase according to your age.
If you sign up at a younger age, for example, 65, you may pay less throughout your life than someone who signs up at 75.
Of course, this doesn’t mean that your costs won’t increase over time; other factors influence this (like inflation).
Attained-Age Medigap Plans
With an Attained-Age rate, your costs increase (often yearly) according to your age.
Attained-age premiums are generally lower for younger buyers but rise as you get older. They may be among the least expensive options at first but could eventually become among the most expensive. Premiums may also rise because of inflation and other factors.
With an attained-age policy, your current age is one variable used to calculate your premium. The timing and size of age-based adjustments can differ by policy. Your premium may also rise because of inflation, healthcare costs, or other considerations unrelated to your age.
Before enrolling, ask how frequently the premium increases because of age and how much the policy’s rates have increased for other reasons during the past several years. Premium rates and increases are regulated at the state level, but the exact review and approval process varies by state.
Community-Rated Medigap Plans
Community-rated plans, sometimes called no-age-rated plans, use a base premium that is not determined by your age. People enrolled in the same policy and rating area generally pay the same base premium regardless of age.
Your base premium does not increase simply because you get older. It can still rise because of inflation, healthcare costs, the policy’s overall claims experience, and other permitted reasons. Your actual price may also be affected by tobacco use, location, or available discounts. Some insurers offer enrollment discounts that shrink over time, so it is important to ask how any discounts work.
Comparing How the Three Pricing Methods Work
Here’s a simplified look at how age typically affects your premium under each pricing method.
| Pricing method | How age is used | Can the premium rise for other reasons? |
| Community-rated | Age does not determine the base premium | Yes |
| Issue-age | Based on your age when the policy is issued | Yes |
| Attained-age | Based on your current age | Yes, in addition to age-based changes |
Coverage Stays the Same, No Matter the Pricing Method
The pricing method does not change a policy’s standardized basic benefits. In most states, two policies with the same plan letter, such as Plan G, provide the same standardized basic benefits regardless of how they are priced. Premiums, discounts, customer service, and certain additional features can still differ. Massachusetts, Minnesota, and Wisconsin standardize Medigap policies differently.
Choosing Between the Three Pricing Methods: Factors to Consider
State law affects which pricing methods insurers may use. In KFF’s most recent comprehensive state review, nine states required community rating for policyholders 65 and older: Arkansas, Connecticut, Idaho, Maine, Massachusetts, Minnesota, New York, Vermont, and Washington. Four states, Arizona, Florida, Georgia, and Missouri, permitted issue-age pricing but prohibited attained-age pricing. The other 37 states and Washington, D.C., allowed insurers to use any of the three methods.
These rules do not mean that every pricing method or plan is available from every insurer. Check current offerings and rules with the insurer or your State Insurance Department.
Attained-Age plans are the most common in many states in the US.
If you’re able to choose between two similar plans, it’s important to think of your current age and how much you would potentially pay over your lifetime on each plan.
No matter which pricing method a plan uses, several other factors can affect what you pay. Your premium can also be affected by:
- the plan and benefit design you choose
- where you live
- tobacco use
- gender in states where it is permitted
- medical underwriting when applicable
- available discounts
Some insurers offer discounts based on marital or household status, multiple policies, annual payments, or automatic payments.
Regardless of the pricing method, premiums can rise because of inflation, healthcare costs, and the policy class’s overall claims experience. An insurer generally cannot single you out for a renewal increase simply because you personally used more healthcare.
How Do You Find Out Which Method a Plan Uses?
Ask the insurance company whether the policy is community-rated, issue-age-rated, or attained-age-rated. If it is attained-age-rated, ask how frequently the premium increases because of age. You can also ask how much the policy’s premium has increased during the past three years because of inflation or other reasons.
A licensed insurance agent, your State Insurance Department, or your local State Health Insurance Assistance Program can also help you compare available policies.
Why This Choice Matters More Than It Seems
Your federal Medigap Open Enrollment Period is a one-time, six-month period that begins the first month you are 65 or older and enrolled in Medicare Part B. During this period, an insurer cannot deny you a policy it sells or charge you more because of preexisting health problems. You will generally have better prices and more policy choices.
After this period, you may need to pass medical underwriting to buy or switch policies unless you have a guaranteed-issue right or additional protection under state law. An insurer may then charge more or deny your application based on its underwriting rules. This means that switching away from a policy that has become expensive may not always be easy.
Frequently Asked Questions
Does the pricing method change what my plan covers?
No. Medigap policies are standardized, so the standardized basic benefits for a given plan letter are identical in most states no matter which pricing method the insurer uses. The pricing method only affects how your premium is calculated over time.
Can my premium still go up on an issue-age or community-rated plan?
Yes. Issue-age and community-rated premiums do not increase because of your age, but they can still increase because of inflation, rising healthcare costs, and the policy class’s overall claims experience. No pricing method locks in your premium forever.
Are all community-rated plans completely unaffected by age?
Age does not determine the policy’s base premium. However, some insurers offer enrollment discounts that shrink over time. Your actual bill can therefore rise as the discount phases out even though the policy is classified as community-rated. Ask about the base premium, discounts, and the policy’s recent rate history.
Can I switch to a different pricing method later?
Sometimes, but not always easily. Outside your one-time Medigap Open Enrollment Period, switching plans in most states means going through medical underwriting, and the insurer can charge you more or decline your application based on your health history. Some states have rules that make switching easier, so it is worth checking the rules where you live.
To Wrap Up
The state you live in and the insurance company you choose will largely dictate whether you end up with an Attained-Age, Issue-Age, or Community-Rated policy.
However, if you choose that plan, it is still up to you. You have to consider whether it’s going to cost you more or less in the long run and whether the perks are worth it.
Need help finding the right plan for you? Our exclusive Medicare workshop will show you what you need to know about Medicare (in simple terms) and help you learn how to choose the best Medicare plan for your needs.
Calvin Bagley is the founder of PlanFit, The Medicare Store, and Nuvo Health. He and his team have helped over 60,000 people navigate Medicare options, and he’s a nationally recognized speaker in the Medicare industry. Most importantly, he’s someone who believes every American deserves clear, honest information without pressure.