Beneficiaries of Medigap plans pay different Medigap premiums by state and age, in most cases. Generally, beneficiaries aged 65 paid lower premiums than those under age 65; in the same way, beneficiaries at 80 years old paid higher premiums than a 65-year-old. We looked up information on the state websites for plan F premiums, using beneficiaries at age 65 for a reference. The premium rates are the states’ advertised rates listed in their comparison guides. Therefore, rates may not be the actual amounts beneficiaries should expect to pay. State health insurance programs just make this information public to assist beneficiaries in selecting their Medigap policies. In all 10 states, average premiums across policies were higher by 73% for beneficiaries under 65, including those with disabilities. This ratio varies by insurance company and state.

Medigap Premiums by State – Consumer Protection, Open Enrollment, and Guaranteed Issue

Medigap rates varied in states according to whether the beneficiaries were covered by consumer protection for those under 65. Beneficiaries under age 65 in five states – CA, FL, CO, MO, and LA – with requirements for open enrollment and guaranteed issue paid 88% or nearly double for the same policy as 65-year-olds. In the five states that did not have requirements for open enrollment and guaranteed issue—ND, MT, KY, IA, and AL—those under 65 paid premiums of 56% more for the same policy than 65-year-olds. However, in these states, few insurance companies made policies available to those under 65. Only one insurer in North Dakota, Montana, Iowa, Alabama, and only eight in Kentucky offered policies to those under age 65.

Not all states that do not have consumer protection have lower premiums for those under age 65. Insurers can choose not to offer policies to every beneficiary under 65 and keep costs down by ensuring only the healthiest people. That practice would influence the figures and analysis, even though it appears quite different on the surface. If insurers make a practice of only insuring healthy people instead of following requirements to cover all Medicare beneficiaries regardless of age or condition, the premiums individuals pay will continue to vary widely and perhaps unfairly.

Also, recipients pay a wide variation of monthly premiums for Medigap insurance because there is no uniformity among the states. At the same time, the cost of age differences is also quite varied. For example, Medicare spent 52% more on policyholders over 80 than those aged 65 in 2009/

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