The Medigap "birthday rule" lets you switch to a different Medigap plan with the same or lesser benefits, without medical underwriting, during a window around your birthday each year. It's currently available in 8 states with similar but not identical rules.
Why this matters: Outside of guaranteed-issue windows, most states allow Medigap carriers to medically underwrite you when you switch policies. If you've developed health conditions, you may be denied or charged higher premiums. The birthday rule bypasses underwriting in qualifying states.
States with a birthday rule (2026):
1. California — Birthday rule established 2020.
- Window: 30 days before to 60 days after your birthday (90 days total)
- Switch from any Medigap plan to any other Medigap plan with EQUAL OR LESSER benefits with the same or different carrier
- Example: switch from Plan G to a different carrier's Plan G at a lower rate without underwriting
2. Oregon — Birthday rule.
- Window: 30 days before to 30 days after your birthday
- Same plan letter only (Plan G to Plan G, Plan N to Plan N)
3. Idaho — Birthday rule (effective March 2022).
- Window: 63 days starting on your birthday
- Switch to any plan with equal or lesser benefits
4. Illinois — Limited birthday rule (effective 2022).
- Window: 45 days following your birthday
- Ages 65–75 only
- Same plan or one with lesser benefits
5. Nevada — Birthday rule (effective 2024).
- Window: 60 days after your birthday
- Switch to any equal or lesser benefit plan
6. Louisiana — Limited birthday rule.
- Window: 30 days before through 63 days after your birthday
- Same plan letter, different carrier
7. Oklahoma — Birthday rule (effective 2024).
- Window: 60 days starting on your birthday
- Same or lesser benefit plan
8. Maryland — Effective 2026 (just enacted).
- Window: 30 days before through 60 days after your birthday
- Same or lesser benefit plan
Other state-specific Medigap protections (not strictly birthday rules):
- New York and Connecticut: Continuous open enrollment year-round — switch any Medigap plan anytime without underwriting
- Maine: Annual switching rights to same-or-lesser plan during a specific month
- Missouri: Anniversary rule — switch within 30 days of your policy anniversary date
- Massachusetts: Continuous open enrollment
- Washington: Switch from one Medigap plan to ANOTHER (any letter, lateral or downgrade) anytime without underwriting
- Vermont: Continuous open enrollment for state-mandated standardized plans
How to use the birthday rule effectively:
- Know your window precisely. Each state's window is different. Mark your calendar.
- Shop quotes BEFORE your window opens. Carriers may take 2–4 weeks to process; start the application within the window but have your research done first.
- Compare same-plan-letter carriers. If you're on Plan G with Carrier A, compare Plan G from Carriers B, C, D in your state.
- Watch for first-year rate teasers. A carrier with a low "new business" rate may have a higher rate increase the next year. Look at the carrier's overall rate history.
- Confirm the new policy is active before canceling the old one. Don't have a coverage gap.
Why carriers want you to know this: They don't. Carriers benefit from member inertia. Most members on Medigap are paying $30–$100/month MORE than they could be paying on the same plan from a different carrier in the same ZIP. The birthday rule (where available) is your annual chance to fix that.
What if your state doesn't have a birthday rule? You'd need to qualify for a guaranteed-issue right (e.g., your Medigap carrier exits the market, you lost employer coverage, you tried Medicare Advantage and want to return within 12 months) or pass medical underwriting. Independent brokers can help assess your underwriting odds.
What to do next: Call (866) 534-1886. We track every state's Medigap rules, rate-shop carriers in your state, and time the switch to your specific window if your state has one. Free.