What is the Maryland Medicare Supplement (Medigap) Birthday Rule?

Summary: The Maryland Birthday rule allows current Medicare Supplement policyholders to enroll in a new Medigap plan of equal or lesser value without underwriting health questions for 30 days following their birthday. Estimated Read Time: 3 min

Table of Contents:

1. What is the Birthday Rule for Medicare Supplement Plans in Maryland?
2. Who is Eligible for the Maryland Birthday Rule?
3. How to Use the Maryland Medicare Supplement Birthday Rule
4. Why Should You Utilize the Maryland Birthday Rule?

Maryland House Bill 247, otherwise known as the Maryland birthday rule for Medicare Supplement plan enrollees, is effective July 1, 2023. If you currently have a Medicare Supplement plan in the state of Maryland, you will be eligible to make a change to your coverage each year around your birthday without the need for medical underwriting.

Below, we review the Maryland birthday rule, how you can qualify, what plans are available, and how this rule can impact your healthcare coverage.

What is the Birthday Rule for Medicare Supplement Plans in Maryland?

The Maryland Medicare Supplement (Medigap) birthday rule offers you the opportunity to switch to a new Medicare Supplement plan of equal or lesser benefits, with any carrier each year starting on your birthday and up to 30 days after. This rule provides flexibility to Medicare Supplement enrollees by providing the option to make an annual change to your benefits without answering underwriting health questions. However, you must be a resident of the state of Maryland to qualify.

While you can switch your Medigap plan at any time year-round, you must go through medical underwriting, and you can be denied coverage for any reason. The birthday rule eliminates that stipulation during this 30-day window, allowing you access to any plan so long as it meets the requirements of the birthday rule.

Who is Eligible for the Maryland Birthday Rule?

The Maryland Birthday Rule applies to any individual enrolled in a Medicare Supplement plan in the state of Maryland. To be eligible for this rule, your Medigap plan must be active before your eligibility window opens. Additionally, your Medicare Supplement plan carrier will be required to notify you of your eligibility up to 60 days but no less than 30 days before your eligibility window begins.

It is important to note that this rule specifically pertains to Medigap plans and does not apply to other types of Medicare coverage, such as Medicare Advantage plans. This rule does not allow those on a Medicare Advantage plan to drop their coverage or allow those enrolled in Original Medicare only to pick up a Medicare Supplement plan without underwriting health questions.

How to Use the Maryland Medicare Supplement Birthday Rule

To use the Maryland birthday rule, you must already be enrolled in a Medicare Supplement plan. Typically, you will enroll in a Medigap plan during your Medicare Supplement Open Enrollment which begins on the day your Medicare Part B becomes active and lasts for 6 months. During this time, you can enroll in coverage without health questions, similar to the birthday rule window.

If you do not enroll in a Medicare Supplement plan during your Open Enrollment Period, you can still enroll in coverage, you’ll just need to qualify medically.

If you are a Maryland Medicare Supplement enrollee and wish to take advantage of this new rule, there are a few different steps you can take. To make the most out of the Maryland birthday rule, you should:

• Review your current Medicare Supplement policy.
• Compare alternative Medicare Supplement plans and carriers.

It is essential to review your current Medicare Supplement policy to ensure it meets both your budget and healthcare needs. Take the time to assess your current plan and consider factors such as premiums, benefits, and overall satisfaction. Additionally, you should compare other Medicare Supplement plans and carriers available in your area to ensure switching coverage is in your best interest.

For example, if you are enrolled in Medicare Supplement Plan F, you should review Plan F options through other carriers as well as plans with lesser benefits, such as Plan G or Plan N.

If you decide to switch to a new Medicare Supplement plan, your next step is to complete the application process within 30 days following your birthday. During the 30-day Open Enrollment period following your birthday, carriers are required to approve your application as long as you have followed the birthday rule correctly.

Why Should You Utilize the Maryland Birthday Rule?

Making a change to your Medicare Supplement coverage during your birthday rule window is not required. However, it may be necessary if you have been diagnosed with certain health conditions that would make you otherwise ineligible to change Medigap plans.

If your current coverage has become too expensive to maintain each month or you are dissatisfied with your carrier’s customer service, this open enrollment window allows you to find a Medicare Supplement plan that may suit your needs better.

As you age, certain factors may change that prevents you from being able to afford your monthly premiums. So, rather than being stuck in a plan that breaks the bank, the Maryland birthday rule allows you to shop around for lower costs.

How To Switch Medigap Plans Using the Maryland Birthday Rule

If you qualify for the Maryland birthday rule and wish to compare plans in your area, we are here to help! Our team of licensed agents are available to help you determine which Medicare Supplement plans and carriers provide the benefits you require at a price that meets your budget.

To begin your plan comparison, complete our online rate form or call us at the number above today!

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