Medigap Birthday Rule is a helpful option for those looking to change Medicare Supplemental insurance plans or providers but, unfortunately, this rule is not available in every state. In this Senior65.com Ultimate Guide, we will go over how the Medigap Birthday rule works, where it is available, and tips for switching if there isn’t a Med Supp B-day rule in your state.
Quick Medigap Overview
Before we delve into the Medigap Birthday Rule let’s first make sure we are all on the same page. If you’re eligible for Medicare, you can add extra insurance coverage in the form of a Medicare Supplement (AKA Medigap) insurance plan. If you haven’t added Medigap yet, please contact Senior65.com and we will help you to start with the best plan possible. Here is a detailed article with a good Medigap overview but just know that Medigap offers private insurance to pay for some or all of the costs that Medicare passes on to patients.
Why is the Medigap Birthday Rule Important?
While the extra Medigap coverage is great, Medigap’s monthly premium prices can increase each year as you get older or in the form of a state-approved rate action. Unfortunately, it isn’t easy to switch your current Medigap to a lower-cost Medigap plan in the future since insurance companies can decline you due to pre-existing conditions. There is no national “open enrollment” period each year when you can switch Medigap plans without going through Medical underwriting. This last sentence is accurate although you may have heard otherwise from the misinformed. Medicare’s Annual Election Period (AEP) from Oct 15-Dec 7 does NOT allow for Medigap switching without answering health questions on the application! With no national switching period, this could mean accepting higher costs or facing rejection when applying to a new plan due to pre-existing conditions. The Medigap Birthday Rule addresses this issue.
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Medigap Birthday Rule to the Rescue!
Some states have passed a Medigap Birthday Rule state law to allow for Medicare Supplement changes without medical underwriting. This law is amazing for anyone on a high-cost plan with a pre-existing condition. If you live in a Birthday Rule state you can switch Medigap plans without answering any health questions and will be approved. With the Birthday rule, you can even switch plans from the hospital and you will be guaranteed to be approved on the new plan.
Most states with the Birthday Rule allow you to switch to a lower-cost version of your plan with a competitor without the risk of being declined. The best way to see if there is a less expensive version of Medigap is to get an Instant Medigap Quote here.
If a lower-cost plan is found with a different provider, you can apply for Medigap online here. You will be asked during the application if you are using the birthday rule. Senior65.com can guide you through the process of making the switch. Our agents WILL NOT charge you a fee for a quote or enroll you in a plan. We receive commissions directly from insurance providers at no extra cost to you.
Which States Have the Medigap Birthday Rule?
Currently, nine states have implemented this rule. Discover and understand how it works in each by following these links:
- Learn more about the California Birthday Rule Switch here.
- Learn more about the Idaho Birthday Rule Switch here.
- Learn more about the Illinois Birthday Rule Switch here.
- Learn more about the Kentucky Birth Rule Switch here.
- Learn more about the Louisiana Birthday Rule Switch here.
- Learn more about the Maryland Birthday Rule Switch here.
- Learn more about Nevada Birthday Rule Switch here.
- Learn more about the Oklahoma Birthday Rule Switch here.
- Learn more about the Oregon Birthday Rule Switch here.
If your state isn’t on the list, you can still change plans. We recommend reading our Switching Medigap plans article which goes into detail about Missouri’s Anniversary rule and other guaranteed Medigap state laws not listed here.
When to Apply Using the Birthday Rule
Explore the timeline for plan changes under the Birthday Rule, which varies based on state regulations. Refer to this comparative chart:
| State | When to Apply? | Can you switch companies? |
|---|---|---|
| California | You had 60 days from your birthday to switch plans | Yes |
| Idaho | You have a 63-day window to switch plans beginning on your birthday | Yes |
| Illinois | The regulation allows Medigap clients, ages 65 through 75, to have 45-day annual open enrollment period after their birthday | No |
| Kentucky | 30 days before and no later than 60 days past the first day of your birth month | Yes |
| Louisiana | 30 days before or up to 63 days after your birthday | No |
| Maryland | You must switch within 30 days of your birthday | Yes |
| Nevada | You have 60 days from the first day of your birth month | Yes |
| Oklahoma | You have a sixty 60 calendar day “open enrollment” period beginning on your birthday | Yes |
| Oregon | Starts 30 days before your birthday and ends 30 days after it | Yes |
Remember: In most states, you can only switch to a Medigap plan that offers benefits equal to or less than your current coverage.
No Birthday Rule in your state yet?
- Write your state leaders telling them you want the Birthday Rule in your state. This is not a partisan issue. Both Blue and Red states above have passed this law because it just makes common sense.
- Read our article “Medicare Insurance Switching: Ultimate Guide” for detailed guidance. There are many options beyond the birthday rule that can allow you to switch Medigap plans without going through Medical underwriting.
- Call Senior65.com and we will help you review your own state’s switching option.
If you want to get an idea of how much different plans cost in your area, you can get an Instant Medigap Quote here. If your state follows the birthday rule, contact Senior65.com at 800-930-7956 about two months before your birthday. We’ll help with plan pricing and arrange a switch to a more affordable option.