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 (Part A and B), 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 prior health conditions. The Medigap Birthday Rule addresses this issue.
Get a Medigap Quote Enroll in Medigap
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 | 60 days after your birthday. You can apply before your birthday, but your requested start date (effective date) must be after your birthday. | 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.
Birthday Rule State by State
Looking for more info? The chart below lists everything state by state. If the Birthday Rule isn’t in your state yet, there’s a link with the latest Medigap rules for your area.
| State | Does it have a Birthday Rule? | Relevant Link |
|---|---|---|
| Alabama Medigap Birthday Rule | No | Alabama Medicare Supplement Explained |
| Alaska Medigap Birthday Rule | No | Alaska Medigap Plans Explained |
| Arizona Medigap Birthday Rule | No | Arizona Medigap Plans Overview |
| Arkansas Medigap Birthday Rule | No | Arkansas Medigap Plans Special Rules |
| California Medigap Birthday Rule | Yes | How Does California’s Medigap Birthday Rule Work? |
| North Carolina Medigap Birthday Rule | No | North Carolina Medigap Plan Dos And Don’ts |
| South Carolina Medigap Birthday Rule | No | South Carolina Medigap Plans |
| Colorado Medigap Birthday Rule | No | Colorado Medicare Insurance | Connecticut Medigap Birthday Rule | No, but have other options. | Medigap Switching In Connecticut |
| North Dakota Medigap Birthday Rule | No | North Dakota Medigap Plans |
| South Dakota Medigap Birthday Rule | No | South Dakota Medigap Plans Options |
| Delaware Medigap Birthday Rule | No | Delaware Medigap Plans Important Rules |
| Florida Medigap Birthday Rule | No | Easy Guide To Florida Medigap Plans |
| Georgia Medigap Birthday Rule | No | Georgia Medigap Plans |
| Hawaii Medigap Birthday Rule | No | Hawaii Medigap Plans: How Do They Work |
| Idaho Medigap Birthday Rule | Yes | Medigap Birthday Rule For Idaho |
| Illinois Medigap Birthday Rule | Yes | Medigap Birthday Rule For Illinois |
| Indiana Medigap Birthday Rule | No | Indiana Medigap Plans: How Do They Work |
| Iowa Medigap Birthday Rule | No | Iowa Medicare Supplement Options |
| Kansas Medigap Birthday Rule | No | Kansas Guide To Medicare Supplements |
| Kentucky Medigap Birthday Rule | Yes | Medigap Birthday Rule in Kentucky |
| Louisiana Medigap Birthday Rule | Yes | Louisiana Medigap Birthday Rule |
| Maine Medigap Birthday Rule | No, but have other options. | Medigap Switching In Maine |
| Maryland Birthday Rule | Yes | Maryland Birthday Rule Explained |
| Massachusetts Medigap Birthday Rule | No | How Do Medigap Plans Work In Massachusetts? |
| Michigan Medigap Birthday Rule | No | Guide To Michigan Medigap Plans? |
| Minnesota Medigap Birthday Rule | No | Minnesota Medigap Plans |
| Mississippi Medigap Birthday Rule | No | Mississippi Medigap Plans Unveiled |
| Missouri Medigap Birthday Rule | No, but have other options. | Missouri Medigap Anniversary Rule |
| Montana Medigap Birthday Rule | No | Montana Medigap Plans |
| Nebraska Medigap Birthday Rule | No | Nebraska Medigap Plans Uncovered |
| Nevada Birthday Rule | Yes | Nevada’s Medigap Birthday Rule |
| New Jersey Medigap Birthday Rule | No | New Jersey Medigap Plans |
| New York Medigap Birthday Rule | No, but have other options. | New York Allows Medigap Members To Switch Plans |
| New Hampshire Medigap Birthday Rule | No | New Hampshire Medigap Plans |
| New Mexico Medigap Birthday Rule | No | New Mexico Medigap Plans |
| Ohio Medigap Birthday Rule | No | Ohio Medigap Plans |
| Oklahoma Birthday Rule | Yes | Oklahoma Adds Medigap Birthday Rule |
| Oregon Birthday Rule | Yes | Oregon Medigap Birthday Rule |
| Pennsylvania Medigap Birthday Rule | No | Pennsylvania Medigap Plans |
| Rhode Island Medigap Birthday Rule | No | Rhode Island Medigap Plans |
| Tennessee Medigap Birthday Rule | No | Tennessee Medigap Plans |
| Texas Medigap Birthday Rule | No | Texas Medigap Plans |
| Utah Medigap Birthday Rule | No | How Do Medigap Plans Work In Utah? |
| Vermont Medigap Birthday Rule | No | Vermont Medigap Plans: Essential Information |
| Virginia Medigap Birthday Rule | No | Virginia Medigap Plans: A Comprehensive Overview |
| West Virginia Medigap Birthday Rule | No | West Virginia Medigap Plans: Rules And Options |
| Washington Medigap Birthday Rule | No, but have other options. | Washington Allows Enrollees To Switch Medigap Plans |
| Washington DC Medigap Birthday Rule | No | Washington DC Medigap Plans |
| Wisconsin Medigap Birthday Rule | No | Wisconsin Medigap Policies |
| Wyoming Medigap Birthday Rule | No | Wyoming Medigap Plans 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 (Source: Medicare.gov).
- 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.