Medicare Supplement Plan Cost Estimator: Calculate Your True Out-of-Pocket Expenses

Understanding your true Medicare Supplement costs requires looking beyond the monthly premium. This guide walks you through estimating total annual costs across all Medigap plans.

Quick Answer

Your total Medigap cost = Premium × 12 + Out-of-pocket costs (deductibles, copays, coinsurance) - What Original Medicare doesn’t cover

Use our Medicare Supplement Penalty Calculator to model premiums and penalties across all standardized plans (A-N) for your age, state, and tobacco status.

Detailed Guidance

What Costs Make Up a Medigap Plan?

1. Monthly Premium: The amount you pay the insurance company each month for coverage. Varies by:

   • Plan type (A through N)
   • Your age (attained-age vs. issue-age vs. community-rated)
   • Your state (some states have lower average premiums)
   • Tobacco use (typically 10-20% surcharge)

2. Annual Deductibles: Only Plan F and Plan G have a deductible option ($2,800 in 2026). Plan N has a $20 copay for office visits and $50 for ER visits.

3. Excess Charges: Plans F and G cover Part B excess charges. Other plans don’t.

4. Out-of-Pocket Maximum: Only Plan K and Plan L have OOP maximums ($7,220 and $3,610 in 2026).

How to Calculate Your True Annual Cost

Annual Cost = (Monthly Premium × 12) + Expected Copays + Expected Deductibles

Example for Plan G (Age 65, Non-Tobacco, Average State):

• Monthly Premium: $145
• Part B Deductible: $240 (you pay this)
• Annual Cost: $145 × 12 + $240 = $1,980

Example for Plan N (Age 65, Non-Tobacco, Average State):

• Monthly Premium: $105
• Part B Deductible: $240
• Estimated Copays (10 office visits): $200
• Potential Excess Charges (if provider doesn’t accept assignment): varies
• Annual Cost: $105 × 12 + $240 + $200 = $1,700

Factors That Affect Your Premium

Factor	Impact
Attained-age rating	Premiums increase as you age
Issue-age rating	Premiums start higher but increase only for inflation
Community rating	Everyone pays the same regardless of age
Tobacco use	10-20% surcharge typically applied
Household discount	5-14% discount if spouse enrolls
Gender	In some states, women pay less

State-Specific Considerations

Some states have unique rules:

• Massachusetts, Minnesota, Wisconsin: Different standardized plans
• Connecticut, Maine, Massachusetts, New York, Vermont: Guaranteed issue rights year-round for certain situations
• California: Birthday rule allows plan changes without underwriting

See our Medigap Guaranteed Issue Rights by State guide for details.

Cost Estimation Checklist

Use this checklist when estimating your Medigap costs:

• Determine your enrollment date and age
• Check if your state uses attained-age, issue-age, or community rating
• Get quotes for at least 3 different insurers (prices vary by 30-50%)
• Factor in tobacco surcharge if applicable
• Ask about household discounts
• Include the Part B deductible ($240 in 2026)
• Estimate copays for Plan N ($20/office visit, $50/ER)
• Consider potential excess charges for non-F plans
• Review annual rate increase history (typically 3-7% per year)
• Calculate total annual cost, not just monthly premium

Frequently Asked Questions

Which Medigap plan is the most cost-effective?

Plan G typically offers the best value for most beneficiaries. It covers everything Plan F covers except the Part B deductible. Plan N is cheaper but has copays and doesn’t cover excess charges. Use our calculator to compare.

How much does Medigap cost per month on average?

Average monthly premiums for a 65-year-old non-tobacco user range from $50 (Plan A) to $200+ (Plan F). Plan G averages $130-$180, and Plan N averages $100-$140.

Do Medigap premiums increase every year?

Yes, most Medigap premiums increase annually. Attained-age rated policies increase due to age and inflation. Issue-age and community-rated policies increase only for inflation and claims experience.

Is Plan F still available?

Plan F is only available if you were eligible for Medicare before January 1, 2020. If you became eligible after that date, Plan G is the most comprehensive option available.

Can I switch Medigap plans anytime?

You can apply to switch anytime, but outside your Medigap Open Enrollment Period or guaranteed issue situations, insurers can medically underwrite and deny coverage. See our Best Time to Buy Medigap Policy guide.

Related Resources

• Medigap Late Enrollment Penalty Calculator
• Medigap Plan G vs Plan N Calculator
• Medicare Supplement Penalty Calculator

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