HEADS UP: New York - 2026 - Medicare Supplemental Rate Increase Applied for by Insurers for 2026

[GailL1]

Medicare Supplemental plans have asked the New York Dept of Financial Services to approve a rate increase at the % of increase stated per each company.

New York Dept of Financial Services 07/02/2025 - Summary of 2026 Medicare Supplement Requested Rate ... 

NewYork is one of the few states in the Union that has continuous enrollment into Medigap plans without any Underwriting.  Thus it opens the door for Adverse Selection - where beneficiaries that are, perhaps, sicker and using a lot of Medicare can obtain a Medicare Supplemental plan at anytime without underwriting and the cost is shared by everybody.

Adverse selection occurs when lower cost or healthier patients opt out of more expensive plans or forego buying insurance until they need it, while higher cost or

sicker patients actively buy more protective insurance (with additional out-of-pocket protections and/or benefits) to protect them from risk. This imbalance in enrollment

results in fewer lower cost or healthier enrollees and a greater number of higher cost or sicker enrollees in insurance products. The higher use of services by higher

cost or sicker patients causes premiums to increase in that insurance product.

Any expected increase in Medicare Supplement premiums from assuring Medicare Advantage enrollees who switch to Traditional Medicare can access affordable Medicare Supplement coverage would depend on the degree of adverse selection. It would also depend on the number of beneficiaries who, when switching to Traditional Medicare, enroll in Medicare Supplement compared to the number of overall Medicare Supplement enrollees. The degree of adverse selection for those switching to Traditional Medicare would likely increase if beneficiaries leaving Medicare Advantage had assured access to affordable Medicare Supplemental coverage.

They have this assurance in New York with its continuous enrollment in Medicare Supplemental plans without underwriting.  The avoidance of this situation is why other state’s Medigap insurers are given the right to underwrite.  

New York Dept of Financial Services.gov - Information for Medicare Beneficiaries 

From the above link: [copy/paste]

Open Enrollment

New York State law and regulation require that any insurer writing Medigap insurance must accept a Medicare enrollee's application for coverage at any time throughout the year. Insurers may not deny the applicant a Medigap policy or make any premium rate distinctions because of health status, claims experience, medical condition or whether the applicant is receiving health care services. However, eligibility for policies offered on a group basis is limited to those individuals who are members of the group to which the policy is issued.

While every Medigap insurer offers both plan A and B for policies sold before June 01, 2010, plans A, B and either C or F for policies sold on or after June 01, 2010, and plans A, B and either D or G for policies sold on or after January 1, 2020, not every company offers all standardized plans.

[w607000c]

AARP Supplemental Healthcare through UnitedHealthcare premiums are going up in 2026.

The rate increase proposed is 17.9% equates to about $50 more. This rate increase is outrageous and unjustified. It is also criminal. With the cost of everything on the rise 17.9% is going to be devastating to millions of people.

I hope AARP will contact the New York State Department of Financial Services Superintendent and persuade him or her to disapprove the proposed rate increase. I follow the activity on Wall Street, and it's no secret that UnitedHealthcare has been taking some hefty losses, this may account for them unjustly proposing such a massive rate increase. 

[GailL1]

@w607000c 

Did you look at the link I posted on the NY DFS site - it isn’t just AARP UHC that is proposing the increase in premiums - all of them - some a lot more than what AARP-UHC is proposing.

NY is getting a kind of a double whammy in their Medicare Supplemental premium prices.

(1) Usage is way up in millions of beneficiaries using their traditional Medicare programs - Part B especially.  We still have until 2030 when all the baby boomers turn 65 and are eligible for Medicare.

(2) since NY has continuous enrollment of Medigap plans without underwriting, and allows beneficiaries to switch plans, premiums reflect this Adverse Selection* phenomenon to which everybody with a Medigap plan will pay.

(3) plus in NY, I believe that those who are less than 65 who have access to Medicare (the disabled - SSDI) and to any Medigap plan just like those who are over 65 - Federal law does not give any protections to those who are less that 65 and their access to a Medigap - in many states, they either cannot get a Medigap plan or they have access to only certain plans and are charged a much higher rate to help cover their increased healthcare cost. 

* Adverse selection occurs when lower cost or healthier patients opt out of more expensive plans or forego buying insurance until they need it, while higher cost or sicker patients actively buy more protective insurance

(with additional out-of-pocket protections and/or benefits) to protect them from risk. This imbalance in enrollment results in fewer lower cost or healthier enrollees and a greater number of higher cost or sicker enrollees in insurance products. The higher use of services by higher cost or sicker patients causes premiums to increase in that insurance product.

But what are your griping about - you can change your medigap plan at any time in NY - so pick another one that is cheaper - well if you can find one in NY. 

From the looks of some of these increases, I bet some insurers may consider moving out of the Medigap market in NY especially if the higher priced ones keep loosing members. 

BTW, your complaint should be registered with the NY Dept of Financial Services who are now contemplating these premium increases - let your voice be heard.  

[pacase1]

You sound as though you work for the Insurance industry or better yet for UHC. You even quoted verbatim a paragraph out their explanation of the rates. My Insurance since I began with my UHC supplemental insurance in 2018 at age 65 has MORE than doubled. When I signed on to UHC it was a doable thing. Yes, I can choose another plan in NY but that isn't really the point here is it? The fact is, they are increasing their rates faster than anyones SSI is. There are those of that feel we too deserve a quality insurance with the same benefits as all. With the rates increasing so fast, They are outpricing themselves. I also wonder, how AARP can support this and advertise that it's affordable. They should clarify this y saying it's affordable to a select customer. If I sound a little angry, I guess I am, I feel I'm in a vise ring squeezed out, at something I began in 2018 thinking I was backing the right horse. If AARP can recommend it, it must be good, after all they are looking out for the seniors, aren't they? 

[GailL1]

@pacase1 wrote

You even quoted verbatim a paragraph out their explanation of the rates.

=========================

My quote came from the New York Dept of Financial Services.gov site - just like my linked showed in my original post.

NY DFS.gov - Information for Beneficiaries 

[GailL1]

@pacase1 

Nope, never worked in the insurance industry- in fact, I have been retired for 20+ years and on Medicare since God was a baby (that’s a long time).  My hobby has been reading everything I can about all types of insurance especially Medicare  and associate coverage.  

Yes, Medigap premiums rise with time.  Medigap is really NOT medical insurance, it is financial protection insurance to prevent a catastrophic medical loss cost.  So, in most states, premiums are primarily based on usage of the gap that it fills - Medicare Part A and Part B.  Plus any reserve that the state may want the insurers to put up for access to their state’s beneficiaries.  

In NY and a few other states, they have what is called an extended guaranteed issue period (open enrollment) where beneficiaries can switch plans AND actually even buy plans outside of the initial enrollment period.  When this happens, a beneficiary with whatever health care condition or cost can buy or switch Medigap plans - this also shifts their RISK to that other plan - thus the Adverse Selection.  

I quoted from the NY DFS.gov site because it explained the NY concept of who can get a Medigap plan and when well.  

In other states, their Medigap rules of eligibility and enrollment is pretty much based on what the Federal law says.  They keep down adverse selection by having specific initial enrollment periods to which are very strict or well defined special enrollment periods.  Risk is minimized or paid for by having UNDERWRITING - which NY and a few other states don’t have.

Premium rates for Medigap are based on state laws.  The more usage by shear numbers, the more risk which state laws allow, the higher the premiums.  

Insurers also vary by state - some insurers may offer very low rates in their beginning in a state - soon they increase rates rapidly to catch up.  One insurer, ACE- went up 30% in 2025.  And Allstate is taking such a hit, they have decided to leave the Medigap marketplace,  In some states, they do not have community rating in all insurers like in NY and a few other states.  They may have rates that are initially set and continue to be raised by other rating methods like attained age.  This would be in addition to the usage and the risk factors.  The older one gets the more the premiums. 

Please do not use the abbreviation of SSI - that is the welfare program of disability - Supplemental Security Income - it does NOT mean Social Security Insurance.  

Medigap premiums have nothing to do with what a Social Security benefit might be - nothing to do with COLA either.  A beneficiary’s pocketbook is what it is - a little or a lot, they budget what they can afford if not they have to make other plans.  

Medicare Part B premiums are also not set by what a beneficiary can afford although low income seniors do get a subsidy to pay for them.  Part B premiums are based on USAGE - and the last Social Security Trustee Report forecast these to be along the line of $ 206 a month in 2026 - up from $ 185 in 2025 - but with only a COLA of around 2.5%.  We will know in October 2025 if these forecast is accurate.  

Yes, any Medigap plan may outprice themselves but in NY and a few other states,  the beneficiary can switch to another insurer with lower premiums.  In most states, this is not possible if the beneficiary cannot pass underwriting.  If they can’t they are either stuck with what they have or they drop it and go to a Medicare Advantage plan OR pay out of pocket the amount that Traditional Medicare does not cover.

Having a Medigap plan is not required by Medicare at all.  

AARP has nothing to do with the premiums or the running of the AARP/UHC Medigap plan - they only get royalties from the sale of such branded plans.

California is now proposing a new Medigap law in their state SB242 - it would allow those who want a Medigap plan to buy them at anytime and they already have a birthday rule where those with a Medigap already can switch their plan.  The analysis done by the state on this new proposal states that therewould be an immediate $ 40 a month increase in cost just for this proposal being enacted.  That’s on top of any other cost increase for usage or birthday rule risk.  It too, I believe is a community rated state.  

I wrote about this in another post that you can find here:

https://community.aarp.org/t5/Medicare-Insurance/CALIFORNIA-Senate-Bill-SB242-Medicare-Supplemental-... 

If you are in NY, take advantage of the laws in your state - at least you have this option.  In fact, switch to another insurer and switch to another plan and share in the risk and really lower your premiums - like to a High Deductible Plan G.

[TRL1111]

Your post is an excellent explanation of the rate increases.  I'll point out, however, that you said you believe California is a community-rated state.  It's not.  AARP/UHC's use of "community rated" makes it almost impossible to understand, so the sure way is to go the plan finder and enter a zip code in whatever state you're thinking about, and enter 65 for the age and look at prices for Plan G for various companies. They'll differ among the companies.  For example, USAA will have a price for the Plan G for the 65-year-old, Blue Cross will have a different price, and State Farm will have a different price.

Then enter age 90, and look at the prices.  Only if each company's price for the supplement for the 90-year-old is the same as that company's price for a 65-year-old does the state have true community pricing.  

I did it for 90007 and the first Plan G that comes up for a 65-year-old is $162 from Washington National Insurance Company.  When I enter 90 as the age, Washington National's  premium is $363.  Since the price isn't the same for both ages, that shows that California isn't community-rated.

And as an aside, for a 90-year-old, the cheapest Plan G is from AARP/UHC, at $312.  For a 65-year-old, AARP/UHC's plan is the 9th cheapest Plan G.  

[GailL1]

@TRL1111 wrote -I'll point out, however, that you said you believe California is a community-rated state.  It's not.

================================

I stand corrected, CURRENTLY CA is not a total community rated state like some others.

• Currently, nine states (AR, CT, ID, MA, ME, MN, NY, VT, and WA) require premiums to be community rated among policyholders ages 65 and older.
• Four states – Arizona, Florida, Georgia, and Missouri – permit issue-age rating but prohibit attained-age rating,
• The majority of states (37 states and D.C.) allow any rating system

.KFF.org- Key facts About Medigap Enrollment 

IF SB242 passes - it will be a mandated community rated state - 

The new California bill SB242 has a comment section in the CA Senate analysis relating to changing this to only community rating.  Actually, when you read this bill and if passed - how could it be any other way?  

CA- SENATE COMMITTEE ON HEALTH Senator Caroline Menjivar, Chair 2) BILL NO: SB 242 AUTHOR: Blakespea... 

SUBJECT: Medicare supplement coverage: open enrollment periods

SUMMARY: Allows for an annual open enrollment in Medicare supplement, also called“Medigap,” insurance with protections from plan denials, and premiums rates based on age, and

health status. Ends the ability of Medigap plans to exclude from enrollment people under age 65 who have end stage renal disease.

THIS Bill     page 3 #5

Prohibits, after January 1, 2026, an issuer of Medicare supplement coverage from denying or conditioning the issuance or effectiveness of any Medicare supplement coverage contract

available for sale in the state, or discriminating in the pricing of the contract because of the health status, claims experience, receipt of health care, medical condition, or age of an applicant, if an application for that coverage is submitted at either of the times described in 2) above.

See the Comment section on page 5 - item #8

“Rules for setting Medigap premium rates. Medicare Supplement plans may set premiums based on the methodologies described below. This bill requires community rating and guaranteed issue, which includes no underwriting or denials based on health status or age.”

Also see page 17 of the 

California Senate Bill 242 Medicare Supplement Coverage: Open Enrollment Periods Report to the 2025–... 

Availability of Medicare Policies

It is possible that SB 242 would result in insurers closing enrollment in the Medicare Supplement plan market in California due to the expanded open enrollment period and community-rated premiums, resulting in less competition and potentially higher premiums. California requires the renewal of existing insurance policies. Therefore, closing enrollment does not mean that existing enrollees would lose their coverage immediately, just that there could be no new entrants. However, the renewed policy would need to comply with the new “pure” community rating rules for pricing premiums.

[pacase1]

Sorry my post was directed to @Gail.1. (Honored Social Butterfly.)

[TRL1111]

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@GailL1 wrote:

But what are your griping about - you can change your medigap plan at any time in NY - so pick another one that is cheaper - well if you can find one in NY. 

Exactly.  One of the reasons supplements in New York state are so expensive is because people CAN change supplements whenever they want, no questions asked.  If I lived there, I'd be checking the pricing at least every six months.  It takes only a couple of seconds.

Also, New York is truly community based pricing (not the fake type AARP/UHC sells in other states, with the "age-related discount").  So a person who's 65 pays exactly the same premium as someone who's 105.  

FWIW, the zip code I always use when looking at supplements in New York just out of curiosity (I'm not in New York) is 10003, in Greenwich Village in Manhattan.  Right now, AARP/UHC is the cheapest plan G available, at $325/month.  The next cheapest is Transamerica at $357.

[GailL1]

@TRL1111 

Yep, they can switch plans which does add risk - New York also has continuous enrollment in Medigap plans without underwriting so that also extends to those who want to buy a Medigap plan LONG after their initial enrollment - They can terminate their Medicare Advantage plan after using it to save premium cost for years and years and then when they are having higher health care cost, dump it and sign up for Trad. Medicare and the medigap plan of their choice.

Did you see some of these % increases in the NY DFS.gov link?  In both group and individual plans - kind of makes me wonder how people in NY afford such premiums.  

Will they continue to afford them is the question.  The ONLY way the state can do this is under the community rated method.  I also think that those who have access to Medicare who are less than 65 (the disabled - SSDI) are also within this same mix and most likely they have higher health care cost just like those that are older seniors.  

Wonder at what premium level will be the breaking point for New Yorkers?