Summary: The Oklahoma Medicare Supplement (Medigap) birthday rule allows Oklahomans to change their Medigap coverage without going through medical underwriting during a 60-day period starting on their birthday. Estimated Read Time: 3 min
Table of Contents:
- What is the Oklahoma Medigap Birthday Rule?
- When is the Oklahoma Medicare Supplement Birthday Rule?
- Who Qualifies for the Oklahoma Birthday Rule?
- How to Switch Coverage During Your Oklahoma Medicare Supplement Birthday Rule
Oklahoma is one of eight states nationwide that offers a birthday rule to Medicare Supplement (Medigap) enrollees. The birthday rule allows those who would not typically qualify to change their Medigap coverage to compare plans once a year and shop for a lower monthly premium. Due to the standardization of Medigap plans, comparing rates in your area and choosing a highly rated carrier with a low monthly premium is always a good choice.
Below, we review the Oklahoma birthday rule, when you become eligible, and how you can benefit from using this unique enrollment period.
The Oklahoma Medicare Supplement birthday rule is an enrollment period unique to Oklahoma residents who are enrolled in a Medigap plan and have had no gaps in their health coverage for more than 90 days since their Initial Enrollment Period. During this time, you can enroll in a Medicare Supplement plan of equal or lesser value to your current plan through any carrier.
Typically, you must medically qualify to enroll in a Medicare Supplement plan or switch plans after your Initial Enrollment Period. However, the birthday rule waives that eligibility requirement for a pre-determined amount of time surrounding your birthday. Hence the name “birthday rule”.
A recent study by the Kaiser Family Foundation shows that 82% of people over age 65 suffer from at least one chronic condition that insurers may see as a reason to deny them Medicare Supplement insurance. The birthday rule allows Oklahomans in this situation the opportunity to change plans when they would not otherwise be eligible.
The birthday rule for Medicare Supplement plans in Oklahoma is a 60-day window that begins on your birthday. This time will be unique for each individual. Thus, you’ll want to be prepared for your window to open and make any changes to your coverage before it closes.
For example, if your birthday is March 1, your birthday rule will open on March 1 and last until April 30. Any changes made to your coverage during your birthday rule window will be effective on the first day of the following month.
There are a few simple qualifications for the Oklahoma Medigap birthday rule. First, you must be a resident of Oklahoma and spend at least 51% of your time in the state throughout the year. Next, you must already be enrolled in a Medicare Supplement plan and not have had a lapse in coverage greater than 90 days since your initial enrollment into Medicare.
It is essential to know that the birthday rule is only available to those currently enrolled in a Medigap plan. If you have Original Medicare and wish to enroll in a Medigap plan for the first time, you will need to undergo medical underwriting. Additionally, if you are currently enrolled in a Medicare Advantage plan you are not able to return to Original Medicare during this time.
If you wish to utilize the Medicare Supplement birthday rule in Oklahoma, there are a few steps you must take. These include researching your options, working with a licensed agent, and enrolling in coverage before your birthday rule window closes.
It is crucial to research Medicare Supplement plans available to you during this time. Remember, you can only enroll in a plan with equal or lesser value. So, you cannot increase your coverage during your birthday rule.
For example, if you are enrolled in a Medicare Supplement Plan G, you can enroll in Plan G through a new carrier or choose to enroll in a plan with lower benefits, like Plan N. You may NOT enroll in Plan F or Plan C as these plans provide more benefits than your current Plan G. If you are unsure which plans you qualify for, comparing Medigap plans is essential.
Additionally, you do not have to stick with your current carrier. You are able to switch to any carrier available in your area. Thus, it is important to work with a licensed agent who has access to multiple carriers to ensure you receive the best premium through the right carrier.
At MedicareFAQ, our agents are here to help you find a plan to adequately fit your healthcare needs and your budget during your Oklahoma Medigap birthday rule. Complete our online rate form to receive a free, no obligation plan comparison today!
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- Bulletin, Oklahoma DOI. Accessed September 2023.