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The Medicare Birthday Rule allows a current Medicare Supplement (Medigap) insurance plan beneficiary the opportunity to switch or change Medicare Supplement plans without medical underwriting around the time of their birthday. Learn which states recognize the Medicare Birthday Rule.
Medicare beneficiaries who have Medicare Supplement Insurance, or Medigap, can switch Medigap plans around the time of their birthday without facing medical underwriting practices that can be used to charge higher rates or deny approval of a policy, but only if they live in one of the nine states that has a Medicare Birthday Rule.
State laws providing this type of enrollment opportunity called the “birthday rule” are different from state to state, and only nine states currently have a Medicare Birthday Rule.
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The Medicare Birthday Rule allows what are called “guaranteed issue rights” that beneficiaries typically only have during their Medicare Supplement Insurance (also called Medigap) Open Enrollment Period or if they have qualifying life events.
When you first become enrolled in Part A and Part B and are at least 65 years old, you will begin a six-month Medigap Open Enrollment Period. During this period, you can sign up for a Medicare Supplement Insurance plan with guaranteed issue rights.
If you have guaranteed issue rights, insurance companies are not allowed to use medical underwriting to charge you a higher plan premium or deny you coverage because of your health status.
Once your six-month Medigap Open Enrollment period is over however, you typically no longer have guaranteed issue rights. And while you are technically free to sign up for or switch Medigap plans at any time, doing so after your Medigap Open Enrollment Period means insurance carriers reserve the right to charge you a higher rate due to any pre-existing conditions or other health concerns. They may even deny you coverage entirely.
There are a few special circumstances that may qualify you for a Special Enrollment Period with guaranteed issue rights.
The birthday rule grants a brief Medigap plan enrollment period to current Medigap beneficiaries around the time of their birthday.
Medicare Supplement plan beneficiaries have guaranteed issue rights and can switch to a different Medigap plan with no medical underwriting if they live in a state that recognizes the Medicare Birthday Rule.
It’s important to note that the birthday rule only applies to current Medigap plan members who are looking to switch to a different plan. It does not apply to those not already enrolled in Medigap who are wanting to join a plan.
As of May 2025, there are 12 states that have adopted a Medicare Birthday rule. The eligibility requirements and other terms of each state Medicare Birthday Rule can vary. Different state birthday rules can vary based on the length of the enrollment period, the plans you may be allowed to enroll in and more.
The 12 states with a Medicare birthday rule include:
Several other states may add a Medicare birthday rule in 2025, based on legislation that has been introduced this year.
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Current Medicare Supplement plan members in California have 60 days from the first day of their birthday month to switch to a different Medicare Supplement plan with the same level of benefits or a lower level of benefits than their current plan.
The new Medicare Supplement plan may be with a different insurance company or the same company as their current plan.
Medicare Supplement beneficiaries in Idaho have 63 days after their birthday to change to a different plan with benefits of an equal or lower level. The new plan may be with a different insurance carrier.
Medicare Supplement plan members in Illinois who are between the ages of 65 and 75 have 45 days from their birthday to switch to a plan with the same insurance company that has a level of benefits equal to or less than that of their current plan.
Medicare Supplement plan members in Indiana who are at least 65 years old are eligible for an annual Medicare Supplement open enrollment period within 60 days of their birthday each year.
During this period, qualified beneficiaries can switch – without any medical underwriting – to a Medicare Supplement plan that has the same letter name as their current plan but is offered by a different insurance carrier than their current plan.
For example:
The Kentucky Medicare birthday rule allows people in the state who have a Medicare Supplement plan to switch to a plan with the same letter name as their current plan but offered by a different insurance carrier within 60 days after their birthday each year.
If you have a Medicare Supplement plan in Louisiana, you may switch to a different Medicare Supplement plan with the same or different plan letter name offered by the same insurance carrier or one of their affiliates within 63 days of your birthday each year.
For example, you could switch from your current Plan G to Plan N offered by your current Plan G insurance carrier or one of their affiliates.
The Maryland Medicare birthday rule begins on a beneficiary’s birthday each year and lasts for 30 days.
During this time, Medicare Supplement plan members may switch to a plan that offers equal or lesser benefits than their current plan. The new policy can be offered by their current insurance carrier or by a different insurance company.
Medigap beneficiaries in Nevada have 60 days from the first day of their birthday month to switch to a plan with the same level or a lower level of benefits than their current plan. The new plan may be with their current insurance company or a different one.
Oklahoma allows Medigap beneficiaries to switch to a different plan of equal or lesser benefits than their current plan and the new plan can be offered by a different insurance carrier or their current carrier.
Beneficiaries have 60 days from their birthday each year to make the switch.
The Oregon Medicare birthday rule gives Medicare Supplement plan members a chance to switch to a plan of equal or lesser benefits from any insurance carrier including their current one.
This open enrollment period starts 30 days before the beneficiary's birthday each year and ends 30 days after their birthday. The new plan coverage typically begins on the first day of the month following the application.
The Utah Medicare birthday rule allows Medicare Supplement plan beneficiaries to switch to an equal or lesser tier Medigap plan offered by their current insurance company with no medical underwriting.
This open enrollment period starts on the beneficiary's birthday each year and lasts for 60 days.
The Virginia Medicare birthday rule offers an annual open enrollment period for Medicare Supplement beneficiaries that starts on their birthday each year and lasts for 60 days.
During this time period, a beneficiary can switch to another Medicare Supplement policy that offers the same benefits as their current policy, regardless of whether it's offered by their current insurance company or a different insurance company.
If you live in a state with a birthday rule and are currently enrolled in a Medicare Supplement Insurance plan, contact a licensed insurance agent today. They can help you review your additional plan options, compare costs and benefits to your current plan and switch plans if you’re eligible.
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Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareSupplement.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
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