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medigap birthday rules

Three New States to Implement Medigap Birthday Rules in 2022

In the majority of states, you are only guaranteed the ability to enroll in a Medigap plan during your Medigap Open Enrollment Period (OEP), which is when you first become eligible for Medicare. Unless you are granted a guaranteed issue right, you will usually have to undergo medical underwriting if you want to sign up for a Medigap policy outside of your Medigap OEP.

However, there are certain states that implement annual Medigap birthday rules, which give you the right to change Medigap plans during the month or two after your birthday. Previously, there were only two states that implemented this type of policy, but starting in 2022, three more states are jumping on the bandwagon.

Which states already have Medicare Supplement Insurance birthday rules?

There are a couple of states that already have Medigap birthday rules in place: California and Oregon.


In the state of California, people who are already enrolled in a Medigap plan have a yearly opportunity to switch to a different plan with benefits that are equal to or lesser than those of their current Medigap plan. The California Medigap birthday rule allows beneficiaries to switch policies during the 60 days following their birthday.


Oregon residents also have an annual chance to modify their Medigap coverage. During the 30 days following the policyholder’s birthday, they can change to the same plan with a different insurance carrier or enroll in a different plan with equal or lesser benefits.

Which states will implement new birthday rules in 2022?

Starting in 2022, there are three states that will begin to implement Medigap birthday rules: Idaho, Illinois, and Nevada. Play close attention to the details of each enrollment period, as each state’s birthday rules differ.


Starting March 1, 2022, current Idaho Medigap enrollees will have an annual opportunity to modify their Medigap coverage during a 63 day enrollment period that starts on the day of their birthday. Beneficiaries can choose a plan that has equal or lesser coverage.


Thanks to a new senate bill, an Illinois birthday rule will come into effect on January 1, 2022. This rule will allow current Illinois Medigap enrollees between the ages of 65 and 75 to change to a new plan during an open enrollment period that starts the day of their birthday and lasts for 45 days after. They must switch to a plan that has the same or lesser benefits.


In Nevada, Medigap enrollees will be have the option to switch to a new Medigap plan with equal or lesser benefits starting January 1, 2022. They can do so starting on their birthday and up to 60 days after their birthday.

When is the best time to enroll in a Medigap plan?

If you haven’t already noticed, you should be aware that all of the birthday rules listed above only apply to beneficiaries who are already enrolled in a Medigap plan. So if you think you will want Medicare Supplement Insurance, we recommend signing up during your Medigap Open Enrollment Period. This enrollment period  begins when you are new to Medicare (usually the month that you turn 65) and are enrolled in Medicare Part B, and it lasts for six months.

If you don’t, you may have to face health underwriting down the line, and insurance companies can charge you higher premiums or even deny you coverage. And if you enroll during your Medigap OEP and live in one of the states mentioned above, you will have the option to switch plans down the line if you no longer want the policy that you initially enrolled in.

How to Choose a Medigap Policy (or Medicare Advantage Plan)

Choosing a Medigap plan is a complicated process. Each plan comes with different benefits, and certain Medigap plans have deductibles or cost-sharing models. That’s why we always recommend consulting with a knowledgeable insurance agent before settling on a plan.

Reach out to the team at Medicare Plans Direct today for a free consultation. We can help you explore your Medicare options and help you find the right coverage for you, whether that be a Medigap policy or a Medicare Advantage plan.

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