What States Have the Medigap Birthday Rule?

A Medigap birthday rule allows policyholders in specific states an open enrollment period each year surrounding their date of birth. Each state’s birthday rules differ. However, not every state offers this enrollment opportunity. Below, we review the six states with a Medigap birthday rule.

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States with a Medigap Birthday Rule

Before 2022, only two states provided Medigap beneficiaries with a birthday rule. Oregon and California were the first.

Now, four additional states are implementing birthday rules for Medicare Supplement policies. These states are Idaho, Illinois, Louisiana, and Nevada.

In each of the four states, rules and regulations surrounding birthday rules are different. Thus, some states allow policyholders to change to another plan or carrier, while others only enable changes within the same insurer.

Below, we discuss how each state utilizes its birthday rule. In addition, we will review how residents can benefit in their state.

California and Oregon

As the originators of the birthday rule, California and Oregon continue to allow residential policyholders to utilize this guaranteed issue right annually.

  • California: The birthday rule in California applies to all residents who already have a Medigap policy. Most importantly, the rule starts 30 days before their birthday and ends 60 days following. During this time, policyholders can change to any plan of equal or lesser benefit with the carrier of their choice. Beneficiaries do not need to answer underwriting health questions.
  • Oregon: Like California, Oregon allows policyholders to change to any carrier or plan of equal or lesser benefit with no health underwriting. The rule begins on your date of birth and ends 30 days following. This gives residents a 31-day period to make changes to their plan.

States Adding a Birthday Rule in 2022

Joining California and Oregon on the list of states with a Medicare Supplement birthday rule are Idaho, Illinois, Louisiana, and Nevada. In 2022, a total of six states will allow their residents an annual birthday rule to review Medigap coverage.

  • Idaho: Medigap policyholders will be eligible to enroll in any plan of equal or lesser benefit. Additionally, the plan may be with any carrier. This rule lasts 63 days, beginning on the policyholder’s birthday.
  • Illinois: Beneficiaries between the ages of 65 and 75 will have the chance to enroll in a plan from their current carrier. However, their new plan’s benefit level must not exceed that of their current plan. This open enrollment window opens on their date of birth and lasts 45 days.
  • Louisiana: The window opens 30 days before your birthday and ends 63 days after your birthday. Thus, you get a 93-day window to change your current Medigap plan. You can switch to a policy of equal or lesser benefit through your current carrier during this time.
  • Nevada: Beneficiaries can change their Medigap plan during a period of at least 61 days. This window opens on the first day of the beneficiary’s birth month. During this time, policyholders can change their Medigap carrier or plan. However, the new policy must be of an equal or lesser benefit level to their current plan.

How Do I Utilize My State’s Birthday Rule?

Firstly, only those with a Medigap plan can use the birthday rule. In short, birthday rules offer a chance to change your Medicare Supplement coverage without answering underwriting health questions. Thus, the rules open up plan options for those who would not otherwise pass the underwriting process due to pre-existing conditions.

If you reside in one of the six states with a birthday rule, the first step is understanding the stipulations in your specific state. However, if you are on a Medicare Advantage plan, this is not an opportunity for you to change to Original Medicare and add a Medicare Supplement.

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If you have a Medigap policy and reside in any state with a birthday rule, fill out our online rate comparison form to find the best premium rate for a policy near you.

At MedicareFAQ, we work with the highest-rated carriers to bring our clients the best healthcare experience possible. We believe education is the key to success with Medicare. Our knowledgeable agents can help answer your questions to ensure you are confident in your Medicare coverage.

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

4 thoughts on “What States Have the Medigap Birthday Rule?

  1. I moved to Nevada from California and have group retirees medicare PPO Advantage plan. I’m now 68 and would like to switch to a Medd Supp plan in Nevada Can I do so without underwriting?

    1. Patrick, moving out of your Medicare Advantage Plans service area grants you a Special Enrollment Period. This lasts up to two full months after the month you moved to Nevada.


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