Medigap premium rating North Carolina: 3 methods

Seniors Insurance Hub 2026-10-16

Medigap premium rating in North Carolina comes down to three methods a company may use: community-rated (also called no-age-rated), issue-age-rated (also called entry-age-rated), and attained-age-rated [1]. The method does not change the benefits of a given plan letter. It changes whether your premium is tied to your age, and in what way [1]. If you expect to keep the policy for years, that difference matters more than the first month's quote, because a standardized Medigap policy is built to renew while you pay the premium [1] [3].

Why the pricing method follows you

A Medicare Supplement policy, often called Medigap, helps pay some costs Original Medicare does not cover [3]. You generally need Part A and Part B. You pay the Part B premium to Medicare, and you pay a separate Medigap premium to the insurance company [2] [3]. Medicare does not pay the Medigap premium [2].

Each company decides how to set that premium, and the method affects what you pay now and later [1]. The benefits in each lettered plan are the same no matter which company sells it. The price is the only difference between policies with the same plan letter [2]. Our Medicare Supplement page explains how these policies sit with Original Medicare. Compare the same letter from company to company, which is the comparison Medicare illustrates with Plan G [2], and use our separate Plan G and Plan N note only for benefit differences, not for the rating method.

The policy is meant to stay with you. As long as you pay the premium, a Medigap policy is guaranteed renewable, meaning it renews automatically each year [3]. All standardized Medigap policies bought after 1992 renew every year, even if you have health problems [1]. The company can drop you only if you stop paying, you were not truthful on the application, or the company goes bankrupt or goes out of business [1]. If the policy was bought before 1992, the company can refuse to renew it if the state approves the cancellation, and you then have the right to buy another Medigap policy [1].

Renewal is why the rating method is not a one-year detail. Premium amounts typically increase each year [2]. Inflation and other factors can raise the premium under every method [1]. Age adds a further increase under only one of the three. A policy covers one person, so you and your spouse each need your own [3]. In North Carolina you are not enrolled automatically. You apply with the company [5].

Community-rated pricing

Community-rated pricing is also called no-age-rated. Generally the same premium is charged to everyone, regardless of age or gender [1]. Your premium is not based on your age. It may go up because of inflation and other factors, but not because you get older [1].

Medicare's March 2026 Choosing a Medigap Policy guide uses illustrations and states that the amounts are not actual costs [1]. In the community-rated example, a 65-year-old and a 72-year-old each pay a $165 monthly premium for the same policy [1]. Other factors, including where you live, medical underwriting, and discounts, can still change the premium [1]. A community-rated quote can also start higher than one priced on current age. Look at the cost now and later, not only the opening bill [1].

Issue-age pricing

Issue-age pricing is also called entry-age-rated. The premium is based on your age when you buy [1]. Premiums are lower for people who buy younger, and they do not change as you get older. They may still go up because of inflation and other factors, but not because of your age [1].

In the guide's issue-age example, a 65-year-old pays a $145 monthly premium, and a 72-year-old buying the same policy pays $175 a month because she is older at purchase [1]. After you buy, getting older does not by itself move you into a new age band. If you later buy a new issue-age policy, the new premium uses the age you are then, not the age on the old application [1].

North Carolina law uses the same idea. The attained-age notice required by state law must say that premiums for other Medicare supplement policies on an issue-age basis do not increase as the insured ages, and that those policies should be compared with attained-age policies [4]. Read that for what it says. It is about age. It is not a promise that the dollar amount never changes. Medicare's inflation warning still sits beside it [1].

Attained-age pricing

Attained-age pricing bases the premium on your current age, so it goes up as you get older [1]. Premiums are low for younger buyers and rise with age. They may be the least expensive at first, and they can eventually become the most expensive. They may also go up because of inflation and other factors [1].

In the guide's attained-age example, a 65-year-old pays a $120 monthly premium [1]. That example then shows the premium at $126 at age 66 and at $132 at age 67 [1]. Those amounts are not a Greensboro quote, or a quote for any other North Carolina town [1].

North Carolina does not leave that fact to a footnote. No insurer may use attained age for Medicare supplement rates unless the method is fully disclosed at application, or at delivery if the purchase is by mail order [4]. All solicitation materials must clearly say that the premiums are based on attained age, which means those premiums will increase each year [4].

The Commissioner sets the form of that notice. It must say that rates increase as the insured ages or by age group. It must include an illustration, based on actual attained age, of the dollar increase over not less than 10 policy years, plus life expectancy at the start of that period. It must also say that issue-age premiums do not increase as the insured ages, and that issue-age policies should be compared with attained-age policies [4]. Ask to see that sheet before anyone signs.

What else can change a North Carolina premium

The rating method is the age rule, not the whole price. The North Carolina Department of Insurance says rates can reflect age, gender, tobacco status, where you live, discounts, and medical underwriting if it applies [5]. A friend's price from another part of the state is not your quote. Community rating, as Medicare describes it, generally charges the same premium regardless of age or gender [1]. Gender can still matter on a policy that is not community-rated [5].

A company may discount the premium for women, non-smokers, or married people, for paying yearly, for electronic funds transfer, or for multiple policies [2]. A Medicare SELECT policy may cost less because it can require certain providers [2]. The Department points to Medicare's comparison tool for current North Carolina plan information [5]. That tool asks for ZIP code, age, gender, and tobacco use before it shows estimated premiums, and you should still confirm the price with the company [2] [5].

Health can change the price outside protected enrollment times. A company may use medical underwriting, or charge a different premium, when you do not have a guaranteed issue right and you are not in Medigap Open Enrollment [2]. That is separate from an attained-age birthday increase. We explain medical underwriting in North Carolina in a separate article.

One more note from the Department: premiums may be higher for Medicare disability beneficiaries than for beneficiaries who are 65 or older [5]. When a disabled beneficiary turns 65, North Carolina says they get a new six-month open enrollment period and can buy any of the standardized Medicare supplement policies [5]. That window is a chance to look again at both the plan letter and the rating method.

For counseling that does not sell insurance, the Seniors' Health Insurance Information Program (SHIIP) helps with Medicare supplement questions [6]. Counselors are not agents, they do not sell or endorse any product, and every county has appointments [6]. The toll-free number is 1-855-408-1212, Monday through Friday [6].

Questions worth asking before you choose

Ask each company whether it uses community rating, issue-age rating, or attained-age rating [1]. If it is attained-age, ask how often the premium increases because of age, and whether the premium rose in the last 3 years for inflation or other reasons [1].

Ask what the premium would be at your age, and which discounts you qualify for [1] [2]. Then set the method next to the plan letter, because the same letter can still age differently on the bill [1].

If you might switch later

The best time to buy is the one-time Medigap Open Enrollment Period. It runs six months, starting the first month you have Part B and are 65 or older, and it does not repeat every year [1] [5]. During it, a company cannot refuse to sell you any Medigap policy it offers, and it cannot charge more because of health problems [1] [5].

In most cases, you will not have a federal right to switch later, unless you are still in that six-month period or you qualify in a specific situation, including a guaranteed issue right [1]. If a company is willing to sell anyway, compare benefits and premiums first, and check your state's rules [1]. Outside open enrollment you may have to answer medical questions, and you may pay more [1]. North Carolina says companies can use medical underwriting to decide whether to accept an application outside that period [5].

If you do replace a policy, do not cancel the first one until you have decided to keep the second [1]. The new application requires you to promise that you will cancel the first [1]. You have 30 days to decide, starting when you get the new policy, and you need to pay both premiums for the month you hold both [1]. Once you cancel the old policy, you cannot get it back [1].

North Carolina also requires a notice, on or with the first page, that you may return the policy or certificate within 30 days of delivery and have the premium refunded if you are not satisfied for any reason [7]. The insurer pays that refund directly to the applicant [7].

A replacement is priced on the new company's method at the age you are then [1]. Some people delay Part B because of employer coverage from current work. The six-month window starts when Part B starts, and waiting can make sense while that coverage is in force [1].

Practical takeaways

Ask every company, by name, whether the policy is community-rated, issue-age-rated, or attained-age-rated [1].
Premiums can rise under all three methods because of inflation and other factors. Age itself raises the premium only on an attained-age policy [1] [2].
Treat the dollar examples in Medicare's guide as patterns. The guide says those amounts are not actual costs [1]. Get a quote that uses your age, tobacco status, and where you live [5].
If the policy is attained-age, read North Carolina's disclosure, including the illustration of increases over at least 10 policy years [4].
The one-time six-month open enrollment is the cleanest time to buy, because the company cannot charge more for health problems then [1] [5]. A later switch can involve health questions [1].
Do not drop a policy you already have until the new one is in force and you have used the free-look period. You may pay two premiums that month, and a canceled policy is not waiting for you [1].

How we can help

Have more questions or want to get in touch? Our team at Seniors Insurance Hub helps people in Greensboro and the Piedmont sort Medigap quotes by plan letter and by pricing method, so a policy still makes sense if you keep it. You can write us through our contact page.

You can reach our team at (336) 937-7501.