CA Medigap Birthday Rule 2020

California Extends Switching Deadline for Medicare Supplement plans

by Katie Banks+ on Aug 11, 2020 | 3 Comments

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Covid 19 has ruined many birthday’s in 2020. The CA Birthday Rule 2020 is one positive change that has come in this year of challenge. CA Senate Bill 407 has made it so residents of the Golden State now have 60 days after their birthday to switch Medicare Supplement (Medigap) plans.

Even if you have a pre-existing condition, you can switch to an equal or lessor benefit plan during this time. This article is only about sunny California. If you live in a different state and want to switch Medicare Plans, please visit our Medicare Switching Guide


What is the Medigap Birthday Rule?

The birthday rule is the nickname for a law that allows those who are already on a Medigap plan to switch to another plan without medical underwriting. In CA, they have created an annual window of 60 days after your birthday to switch plans - hence the name “birthday rule.”

Most states do not have a birthday rule or anything similar. In other states, those with Medigap plans who want to switch to a better-priced competitor have to fill out an application and answer questions about their current health condition to be approved.

Yes, even in California, Medicare insurance providers can turn you down for certain pre-existing conditions if you try to switch outside the birthday-rule period.

When does the New Birthday Rule 2020 law go into effect?

The CA birthday rule begins on July 1, 2020. The period allows for 60 (sixty) days after your birthday to switch to certain Medigap plans.

To qualify for the Birthday rule you must:

  • Live in California
  • Have a Medigap plan in force
  • Switch to a plan with equal or lesser benefits
  • Act before 60 days have passed since your birthday

What is an Equal or Lessor Benefit Plan in 2020?

This is a good question because the rules regarding “equal” plans have changed. The birthday rule law requires you to only switch to a lettered plan that has the same or less benefits than your current plan.

By this logic those with Medigap Plan F could switch to Medigap plan G, because G offers less benefits than Plan F (G doesn’t cover the Part B deductible). If you wanted to go from a G to and F you cannot make the birthday rule switch. That hasn’t changed.

In the past, however, you were previously unable to switch from Plan F to an Innovative Medigap F (a plan that includes vision and hearing benefits), as insurance providers stated they were not equal. That has changed.

The CA legislator has now clarified that all lettered plans are considered equal, meaning you can now switch from a standard F to an Innovative F (also sometimes known as a Medigap F Extra) using the birthday rule. If you are not sure which plans you can switch to using the birthday rule, please give us a call at 800-930-7956.

Can’t I just switch my Medigap plan during the annual Open Enrollment?

There is NO annual open enrollment for Medigap. You can switch Medigap plans at any time, but if 6 months have passed since your initial enrollment period (and you are outside your birthday rule period), you will have to go through medical underwriting as described above.

Medicare Advantage (MA) and Part D have an annual election period each year that allows you to switch MA or Drug plans, but Medigap does not. That is why we like the Birthday rule so much and love the expanded rules for 2020.

Next steps for the CA Birthday Rule

1) Check your bill to confirm the price of your current Medigap plan
2) Check our instant online Medigap quotes to see competitive prices. 
3) Call Senior65 at 800-930-7956 before it has been 60 days from your birthday. 

Senior65 will help you switch plans right over the phone. There is no fee for this service and we guaranteed the lowest priced plan available by law. 

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Reader Comments and Questions

By A concerned senior on August 12, 2020

Obama said we couldn't be turned down for medical reasons. How it is possible?

The Affordable Care Act (AKA Obamacare) has a provision that requires that all applicants must be approved regardless of their health condition. This law only applied to medical insurance for those under 65. Medicare Supplement plans can (and do!) turn down people for pre-existing conditions. This is why it is important to apply for Medigap when you are first eligible since those persons over 65 and new to Medicare Part B are guaranteed to be approved. If you don't sign up when first eligible or you try to switch outside the CA birthday rule, you may be turned down for pre-existing conditions. Give us a call here at senior65 if you need help switching.
-Eric from Senior65.com


By Harry on August 12, 2020

so if I understand correctly my period would be from September 16th which is my birthday, to December 15th, is that correct?

Harry,
That is how the law is written. Some insurance providers may interpret the window differently and a few have actually extended it even longer in the past. Give us a call and we can review how it would work for the plans you are considering switching too.
-Chris from Senior65.com


By Miguel on August 11, 2020

I used to live in CA, signed up for Medigap but moved to another State. I was allowed to keep my Medigap plan that I bought in Cali. Can I use the birthday rule even though I live in 'zona?

Miguel,
You must be currently living in CA to exercise the Birthday Rule. We can help you switch in AZ but you could not take advantage of the Birthday Rule. Give us a call to explore your options. There is never a fee for our service.
-Michelle from Senior65.com










PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.

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