Cheapest Medigap Plans by State 2026

Here's something that confuses people until they understand it: Medigap benefits are federally standardized. Plan G is Plan G. The same coverage. The same benefits. Regardless of which state you're in or which carrier you buy from.

And yet a 65-year-old woman can pay $138/month for Plan G in Nashville and $354/month for the same Plan G in New York City. That's a $2,592/year difference for identical coverage.

How does that happen? Three reasons: healthcare cost geography, state regulations, and how carriers are legally allowed to price their policies.

Healthcare cost geography is the obvious one. States with higher medical costs—California, Florida, New York—have carriers paying out more per member, which gets priced into premiums. Rural Tennessee has lower average medical costs than Manhattan. That flows through.

State regulations matter because some states impose additional consumer protections, mandate guaranteed issue periods, or have insurance departments that are more or less aggressive about approving rate increases. States with stronger consumer protections often end up with higher average premiums because carriers build in more pricing cushion.

But the biggest driver is the rating method carriers use, and this is where most people get confused.

Every Medigap carrier uses one of three rating methods to price their policies. Understanding this changes how you should think about what you're buying.

Attained-Age Rating Your premium is based on your current age. It starts lower when you're young and rises every year as you get older. Most carriers use this method. Most states allow it. If you enroll at 65 with a $155/month premium, you might be paying $280/month by age 80 from that age increase alone, plus annual rate adjustments on top.

The upside: lowest initial premiums. The downside: premiums become more expensive as you age, precisely when your income may be declining and your healthcare needs are increasing. You get the bill when you can least afford it.

Issue-Age Rating Your premium is locked to your age at enrollment and doesn't increase as you age. So if you enroll at 65 at $165/month, your premium doesn't go up because you turn 66 or 70. Carriers still apply annual rate adjustments for inflation and claims experience—just no age-based increases.

Used in a smaller number of markets. Generally results in premiums that are slightly higher than attained-age at enrollment but substantially lower in your 70s and 80s. If you're planning to stay on the plan long-term, issue-age pricing often wins the 20-year math.

Community Rating Everyone in the same geographic area pays the same premium regardless of age. A 65-year-old and a 78-year-old in New York pay the same rate. This sounds unfair to younger enrollees but it completely eliminates the pricing spiral that hits people on attained-age plans in their late 70s.

Only a handful of states use community rating or require it: Connecticut, Maine, Massachusetts, Minnesota, New York, and Washington (for certain plans). If you live in one of these states, your initial premium is higher than the national average but your 75-year-old premium is dramatically lower than what attained-age policyholders pay in other states.

The practical impact: in New York at $354/month for Plan G at age 65, the premium stays at roughly that level at age 80. In Georgia where attained-age Plan G starts at $131/month at 65, you might be paying $350+ by age 80 anyway—and that's assuming only moderate annual increases.

These are real 2026 market ranges for Plan G at age 65, female, non-smoker, based on available carrier pricing. Your exact rate will vary by ZIP code and specific carrier, but these ranges represent the market in each state.

Lowest-Premium States:

Tennessee: $138–$175/month. Consistently one of the cheapest markets in the country. Carriers like Cigna, Aetna, and Mutual of Omaha compete aggressively here. Nashville and Memphis have multiple carriers under $155.

Indiana: $144–$180/month. Indianapolis and surrounding areas see some of the most competitive Medigap pricing nationally. Strong competition between carriers keeps rates down.

Missouri: $145–$182/month. Kansas City and St. Louis markets offer solid Plan G options under $165. Cigna is particularly competitive.

Arkansas: $143–$178/month. Little Rock market is affordable. Not many people think of Arkansas for retirement but the Medicare supplement pricing is genuinely strong.

Alabama: $147–$183/month. Birmingham and Mobile markets offer competitive pricing from multiple carriers.

Mississippi: $142–$176/month. Among the cheapest in the Southeast. Lower cost of living flows through to healthcare costs.

Oklahoma: $148–$185/month. Tulsa and Oklahoma City offer sub-$165 Plan G options from major carriers.

Kansas: $149–$184/month. Mid-range of the low-cost tier.

Mid-Range States:

Texas: $158–$215/month. Large state with significant variation. Houston and Dallas are mid-range; rural Texas can run lower. Cigna at $167 in Dallas is strong.

Georgia: $150–$205/month. Atlanta runs $131–$198 depending on carrier at 65. Competitive market.

North Carolina: $155–$205/month. Charlotte and Raleigh have good carrier competition.

South Carolina: $155–$195/month. One of the more affordable coastal states.

Ohio: $158–$208/month. Columbus, Cleveland, and Cincinnati all have multiple carriers competing under $185.

Kentucky: $152–$197/month. Louisville and Lexington are affordable markets.

Michigan: $160–$210/month. Detroit metro runs a bit higher; Grand Rapids area is more affordable.

Virginia: $163–$215/month. Northern Virginia commands a premium due to DC-area healthcare costs; rest of state is more moderate.

Colorado: $162–$218/month. Denver metro is mid-range; rural Colorado is cheaper.

Wisconsin: $158–$205/month. Uses a modified standardized plan structure but broadly comparable.

Iowa: $155–$198/month. Des Moines market is competitive.

Nebraska: $157–$200/month. Omaha is a reasonably priced market.

Utah: $160–$208/month. Salt Lake City is mid-range with good carrier competition.

Higher-Premium States:

Pennsylvania: $175–$230/month. Philadelphia metro drives up the average; western PA is more affordable. Excess charges are banned here which actually makes Plan N more attractive.

Illinois: $162–$225/month. Chicago metro is higher; downstate Illinois is significantly cheaper—you can find sub-$170 Plan G outside Chicago.

New Jersey: $185–$255/month. High healthcare costs, strong consumer protections, higher premiums as a result.

Washington: $178–$240/month. Seattle area is expensive; eastern Washington is more moderate.

Oregon: $172–$235/month. Portland metro runs high; rural Oregon is cheaper.

Arizona: $168–$228/month. Phoenix metro is mid-to-high; Tucson and smaller markets are lower.

Nevada: $165–$225/month. Las Vegas market is moderately priced with decent carrier competition.

Massachusetts: Uses its own standardized plan structure. 'Core' plan is roughly equivalent to Plan G. Community rating applies. Average premiums for a 65-year-old run $200–$280/month but age-based increases don't apply.

Connecticut: Community rating. Premiums at 65 run $220–$310/month. Guaranteed issue year-round.

Highest-Premium States:

Florida: $185–$310/month at age 65. This is a wide range because Florida has extraordinary variation by county and city. South Florida (Miami-Dade, Broward) commands the highest rates in the state—$250–$310/month. Central Florida (Orlando area) runs $205–$255. Northern Florida is more moderate at $185–$220. Florida's large elderly population drives up utilization and carrier costs.

California: $192–$275/month at age 65 in most markets. Los Angeles and San Francisco command the top of that range. More moderate markets like Fresno and Sacramento run closer to $200–$225.

Maine: Community rating. $240–$330/month. Guaranteed issue but premiums reflect the community-rated structure.

New York: Community rating, all ages. $330–$380/month. The most expensive state in the country for Medigap at age 65, but also has the best consumer protections and the clearest long-term value for people who live to 80+. No underwriting at enrollment at any age.

The cheapest carrier varies by state and even by ZIP code within a state. But there are consistent patterns.

Southeast (GA, TN, AL, MS, SC, NC, FL): Cigna is frequently the price leader across the Southeast for Plan G. In Atlanta, Nashville, and Charlotte, Cigna is at or near the bottom of the pricing range consistently. Aetna is competitive in Florida and Georgia. Blue Cross Blue Shield affiliates vary—BCBS of Tennessee is competitive; BCBS of Florida is not typically the cheapest option.

Midwest (OH, IN, IL, MI, MO, KS, NE, IA): Mutual of Omaha is strong throughout the Midwest. Based in Omaha, they have a long history in these markets and competitive pricing particularly for Plan G. Cigna is competitive in Missouri and Kansas. UnitedHealthcare/AARP tends to be mid-market rather than cheapest.

South Central (TX, OK, AR, LA): Cigna and Aetna compete aggressively in Texas—Dallas and Houston have multiple carriers under $170 for Plan G at 65. Humana has competitive pricing in Oklahoma. Smaller regional carriers sometimes undercut the nationals in Louisiana.

Northeast (PA, NJ, NY, CT, MA, ME): New York, Connecticut, Maine, and Massachusetts all have community rating—the playing field is more level and less variation between carriers. In Pennsylvania and New Jersey, UnitedHealthcare/AARP and Aetna tend to compete most aggressively. BCBS affiliates are relevant but not always cheapest.

West (CA, WA, OR, NV, AZ, CO, UT): California is a particularly competitive market with many carriers. Blue Shield of California, Cigna, and Aetna all compete. Washington and Oregon have Regence BCBS and Providence as significant local players. Arizona has strong competition from national carriers—Cigna and Aetna both price aggressively in Phoenix.

Mountain (CO, ID, MT, WY, NM, SD, ND): Thinner markets with fewer competing carriers. Some states have only 3–5 carriers offering Medigap. Mutual of Omaha and Cigna tend to appear here; some states have local BCBS affiliates as major players. North Dakota and Wyoming are notably small markets where you may have limited options.

Always check: the national ranking of carriers doesn't translate directly to every ZIP code. In some rural markets, the 'cheapest nationally' carrier doesn't operate, and a regional carrier is 15% lower than the next national option. Always quote at least 5–6 carriers in your specific county.

Beyond just picking the cheapest carrier in your state, there are structural ways to reduce your Medigap costs that most people don't know about.

Household discounts: Most carriers offer discounts of 5–14% if two people in the same household are both enrolled in a Medigap plan from that carrier. They don't have to be on the same plan letter—one can be on Plan G and the other on Plan N. In many markets, a $155/month Plan G becomes $137/month with a household discount. That's $216/year back per person. Always ask.

Annual versus monthly premium payment: Some carriers give a discount—typically 2–3%—for paying annually instead of monthly. Modest savings but real.

Pay attention to the Part D bundling pitch: Some agents will steer you toward a carrier because they sell both Medigap and Part D plans together. The Medigap and Part D are separate products with separate premiums—you can and should shop them independently. Don't accept a more expensive Medigap plan because it happens to come from the same company as your Part D.

Time your enrollment right: Some carriers in some states have slightly lower rate bands depending on the month you enroll relative to your birthday. This is not universal but worth asking about.

Issue-age states are underrated for long-term savings: If you live in a state where issue-age rating is available, the slightly higher initial premium often beats attained-age plans in 10-15 year scenarios. Run the 15-year cost comparison, not just year one.

Check Medigap Select plans: In some states, carriers offer 'Select' versions of Medigap plans that require you to use specific hospital networks in exchange for lower premiums—savings of 15–20% are common. If you live near the designated hospitals and don't travel frequently, these can be excellent deals. These are especially worth checking in California, Ohio, and Michigan where Select networks are well-developed.

Revisit your plan annually: Unlike Medicare Advantage plans, you can't change Medigap plans annually during open enrollment without going through underwriting. But if you're in good health, it's worth getting a fresh quote every 2–3 years to see if you'd save money switching carriers for the same plan letter. Many healthy people successfully switch to save $40–$80/month on identical coverage.

This question gets debated in Medicare circles. The short answer: community-rated states are a better deal for most people who plan to live past 78 or so.

Here's the math that most people don't run. In New York at $354/month for Plan G at age 65, you're paying $4,248/year from day one. In Georgia where Plan G starts at $131/month, you're paying $1,572/year at 65. The Georgia plan costs $2,676/year less initially.

But the Georgia plan uses attained-age pricing. Assume 5% annual increases from aging plus 3% from company rate adjustments—roughly 8% total annual increase. By age 75, that Georgia plan runs approximately $285/month. By age 80, it's approximately $420/month. By age 85, north of $600/month.

New York's community-rated plan doesn't increase from aging—only from market-wide rate adjustments. If the New York plan grows at 3% per year (inflation/claims, no age component), by age 75 you're at $476/month. By age 80: $552. By age 85: $640.

So the Georgia plan starts dramatically cheaper but catches and passes New York rates somewhere in the mid-70s, and by age 80+ the community-rated New York plan may actually be more affordable.

For people who enroll at 65 and stay healthy until 75, then need significant care from 75–85+, community rating provides the most protection when you're most vulnerable. The premium you pay at 65 in New York is subsidizing people in their 80s—but someday you'll be in your 80s too.

For people who believe they won't make it into their late 70s, or who plan to switch plans frequently or relocate, the low initial premium of attained-age states looks more attractive.

For most people with reasonable health expectations and no reason to believe they won't live into their late 70s and beyond: community-rated states are not the ripoff they appear to be at first glance.