What states have the Medigap "birthday rule" and what is it?

Question

Robert Barco · Accepted Answer

As of July 2025, there will be ten states that will have a "birthday rule" where existing owners of Medigap plans can change plans or change Medigap companies without underwriting. The ten states with the "birthday rule" are, California, Idaho, Illinois, Maryland, Oregon, Nevada, Louisiana, Kentucky, Utah, and Virginia.

Answered by Robert Barco on April 27, 2025

Broker Licensed in OH

Answered by Robert Barco Medicare Insurance Agent

Steve and Sue Brauer · Answer

Hi, thanks for watching. So the question is, what states have the Medigap birthday rule and what is it? The Medigap birthday rule is in California, and the way it works is you have a 60-day window where you can switch from one Medicare supplement to another as long as it's equal or lesser in value with no underwriting. That means the 60-day window begins the first of the month of your birth month and then lasts for 60 days after that. You can only switch from one Medigap plan to another, and it's got to be equal or lesser in value. Now this does not apply if someone's on a Medicare Advantage plan and they want to go to a Medigap plan. It only applies from one Medigap to another Medigap of equal or lesser value. California has that rule. Arizona does not.

Mike Alexander · Answer

Many states have this rule with more added each year, check the states you are in for details.
States that has this rule , tend to have more costly premiums

Terri Reagin · Answer

California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah all have the birthday rule.

Richard Moreno · Answer

The birthday rules applies to Medicare beneficiaries in eligible states that already have a medigap plan. The rule states that you can change plans without  having to go to underwriting for approval.

Janix Barbosa-LLanos · Answer

In my role I can provide general educational information.
Some states offer the Medigap “birthday rule” which allows switching Medigaps plans around your birthday without Medical underwriting. States like California, Oregon, Illinois, Idaho, Louisiana, and Nevada have this rule. 
For personalized advice or plan details, I am happy to offer you in-person appointment.

This information is for educational purposes only and does not constitute specific advice. I do not offer every plan available in your area. For full listing of available plans, please visit Medicare.gov or contact 1800-MEDICARE.

Karen Murray · Answer

A Medigap “birthday rule” provides current Medigap enrollees with a short, guaranteed-issue window each year around their birthday to switch plans without undergoing medical underwriting (usually to the same or lesser benefits; exact rules vary by state). 

States with birthday rules (as of Sept 2025):

CA: 60 days from the first day of your birth month; equal or lesser benefits; can change carriers. 
California Department of Insurance

OR: 30 days from the first day of your birth month; equal or less; can change carriers. 
Oregon SHIBA

ID: 63 days after your birthday; equal or less; can change carriers. 
Idaho Department of Insurance

IL: 45 days after your birthday (ages 65–75); equal or less; same carrier or affiliate. 


MD: 30 days after your birthday; equal or less benefits. 


NV: 60 days from the first day of your birth month; equal or less; can change carriers. 
Nevada Division of Insurance

LA: 63 days after your birthday; equal or lesser; generally same carrier/affiliates. 


OK: 60 days after your birthday; similar/equal or lesser; can change companies. 
Oklahoma Insurance Dept.

KY: 60 days after your birthday; same benefits; can change carriers. 

UT (effective May 7, 2025): 60 days after your birthday; equal or lesser; same insurer only. 
Utah Legislature
+1

VA (effective July 1, 2025): 60 days after your birthday; same letter plan with any insurer. 
Virginia SCC

WY (effective June 4, 2025): 63 days after your birthday; equal or less; can change plan/carrier. 
Wyoming DOI

IN (effective Jan 1, 2026): 60 days after your birthday; same letter plan with any insurer. 
LegiScan
+1

Related protections: Missouri has an anniversary rule (60-day window around your policy anniversary to switch to a same-letter plan, often with a new carrier); Washington lets you switch anytime to equal/lesser benefits with the same insurer; CT & NY have year-round Medigap guarantee

Steve Thornton · Answer

The Medigap birthday rule lets you change your Medigap plan around your birthday without health questions — as long as you switch to a plan with equal or lesser benefits.

States with a Birthday Rule:
	•	California
	•	Oregon
	•	Idaho
	•	Illinois
	•	Nevada
	•	Louisiana (recently adopted, with slight differences)

Each state has its own version of the rule, including how long the window lasts (typically 30–63 days after your birthday).

It’s a great way to shop for a better premium or company without medical underwriting!

Patrick Metcalf · Answer

The Medigap “birthday rule” allows people who already have a Medicare Supplement (Medigap) policy to switch to another plan of equal or lesser benefits each year around their birthday without medical underwriting, meaning no health questions or penalties for pre-existing conditions. The specific window and restrictions vary by state, but it generally gives beneficiaries a 30–60 day period to change plans freely.

States with a birthday rule (as of 2025): California, Oregon, Idaho, Illinois, Louisiana, Maryland, Nevada, Oklahoma, Kentucky, Utah, Virginia, Wyoming, and Indiana (effective 2026).

Tony Spikes · Answer

Contrary to what you read on the Internet or AI, there is only about six states that have the birthday rule in effect. The state that I’ve had the most experience with birthday rule is Kentucky. It’s good for the birth month the month before or the month after. Guaranteed issue to get a plan that is the same coverage or you can step down to lower coverage. If someone has a F plan, they can go with Plan F or G. G to G or step down to N.  
It is better all the way around if a person can qualify to apply at least 4 months before the Birth month.

Steven Bleicher · Answer

Every single State uses the birthday rule. That means that there is a 7-month window when you are about to turn age 65, when you can enroll with Medicare. First of all, you are eligible on the first day of your birthday month. Ergo, if your birthday is June 29th, then June 1st is your date of eligibility. So, the window is: 3-months before your birthday month, your actual birthday month and then three-months after your birthday month for a grand total of seven months!

Answered by Steven Bleicher on April 26, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

The "birthday rule" allows Medicare beneficiaries who are covered by a Medicare Supplement (Medigap) plan to switch their Medigap policy to another of equal or lesser benefits during a designated period around their birthday, without having to answer health questions on the application. 

The rule provides a guaranteed issue right for Medigap plan changes within a specific timeframe and is beneficial to beneficiaries who are usually unable to get through underwriting because of health issues.

As of right now, the following states have implemented this rule:
 * California
 * Idaho
 * Illinois
 * Kentucky
 * Louisiana
 * Maryland
 * Nevada
 * Oklahoma
 * Oregon

Indiana will be implementing this rule in January 2026.

Rick Boyd · Answer

As of 2025 there are 9 states that have some form of the Medigap Birthday Rule. The states are California, idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, and Oregon. Each state has differences in the amount of time around your birthday, to apply with a different company. While most allow you to move to the same or a lower coverage, and change companies, other states allow only like coverage to like coverage with a different company. All of these scenarios come with no medical underwriting.
The best advice is before your birthday, speak with a licensed Medicare insurance specialist to see what your options are in your specific state.

Yasmery Vargas · Answer

There are 8 states currently that have the Medigap Birthday rule. The Medigap Birthday Rule allows you to move from one supplement plan to the next without underwriting. Each state has a unique set of rules and time frame. Look at the state's specific rules for exact time frame. Oregon, Idaho, Illinois, Oklahoma, California, Nevada, Maryland, Louisiana.

Answered by Yasmery Vargas on April 29, 2025

Agent Licensed in PA

Answered by Yasmery Vargas Medicare Insurance Agent

Chad Watkins · Answer

CA, ID, IL, LA, MD, OR, OK and NV all have a Medicare birthday rule. Rules vary by state (for example IL it is only available for ages 65 to 75) but the general idea is that around your birthday, you can switch your Medicare supplement plan to one of equal or less value without going through underwriting and worrying about pre-existing conditions.

Answered by Chad Watkins on May 14, 2025

Agent Licensed in NJ, AK, AL & 48 other states

Answered by Chad Watkins Medicare Insurance Agent

Jeffrey Barone · Answer

Currently 8 states. California, Idaho, Illinois, Louisiana Maryland. Nevada, Oklahoma and Oregon. 
It’s when subscribers can switch their Medigap plan on their birthday without medical underwriting

Fred Manas · Answer

The Medigap "birthday rule" is a policy that allows individuals in specific states to change their Medicare Supplement (Medigap) plan without medical underwriting during a designated period around their birthday. Currently, nine states have a version of this rule: California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, and Oregon. 
Here's a more detailed explanation:
Purpose:
The birthday rule aims to provide flexibility for Medigap policyholders to switch to a different plan without facing potential medical underwriting issues, such as higher premiums or denial of coverage due to health conditions.
Timeline:
The rule allows a specific window of time around the policyholder's birthday to make the switch.
How it works:
During the birthday window, individuals can switch to a different Medigap plan, as long as it's of equal or lesser benefits than their current plan.
State Variations:
While the concept is similar across these nine states, the specific rules (e.g., the length of the birthday window, the types of switches allowed) can vary.

Mary Brown · Answer

States with a Medigap Birthday Rule (as of 2025)
California
60 days
Starts on your birthday. You can switch to any plan with equal or lesser benefits.
Oregon
60 days
Begins on your birthday. You can change to any insurer or plan of equal or lesser benefits.
Idaho
63 days
Starts on your birthday. You may switch to a plan of equal or lesser benefits, including to a new carrier.
Illinois
45 days
Applies only to people aged 65–75. Begins on your birthday.
Nevada
60 days
Starts on your birthday. Switch to a plan of equal or lesser benefits.
Louisiana
63 days
Starts on your birthday. Same or lesser plan, new or same carrier.
Oklahoma
60 days
Starts on your birthday. Must switch to equal or lesser benefits.
Missouri
“Anniversary Rule” – 30 days before & after Medigap policy anniversary
Allows switching to the same plan type with another carrier, regardless of birthday.
Kentucky
Effective Jan 1, 2025
60 days from birthday; switch to same or lesser plan, no underwriting.
Maryland
30 days (called “Open Enrollment Period”)
Begins on your birthday month. You can switch to a plan of equal or lesser benefits.
Oregon, California, Idaho, Illinois, Nevada, Louisiana, Kentucky, Maryland, Missouri, Oklahoma
—

Mark Boone · Answer

The Medigap Birthday Rule is in effect in nine states: California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, and Oregon. This rule allows existing Medigap policyholders to switch to a new plan of equal or lesser benefits without needing medical underwriting around their birthday

Answered by Mark Boone on December 1, 2025

Agent Licensed in MN, FL, MI & NC, OH, SC & VA

Answered by Mark Boone Medicare Insurance Agent

Marcie Barnes · Answer

California, Idaho, Oregon, Kentucky, Nevada and Maryland.

Andrew Kelly · Answer

The Medigap Birthday Rule is a regulation in certain U.S. states that allows Medicare beneficiaries to switch their Medigap (Medicare Supplement) insurance plans without medical underwriting around their birthday. This gives people a chance each year to change plans without worrying about being denied or charged more due to health conditions.

States with a Medigap Birthday Rule (as of 2025):
California

Oregon

Idaho

Illinois (similar rule, but not called the Birthday Rule)

Cheryl Lyons · Answer

Yes — several states have what’s called a Medigap “Birthday Rule”, which gives current Medigap policyholders a once‑a‑year window around their birthday to switch to a different Medigap plan without medical underwriting (meaning no health questions or pre‑existing condition denials).

States with a Medigap Birthday Rule (2025)

These states currently offer a birthday‑based guaranteed issue period (exact windows and rules vary by state):

California – 30 days before through 60 days after your birthday

Idaho – 63 days from your birthday

Illinois – 45 days from your birthday (ages 65–75; may have carrier limits)

Kentucky – 60 days from your birthday

Louisiana – 63 days from your birthday

Maryland – 30 days after your birthday

Nevada – 60+ days starting in your birth month

Oregon – ~30 days around your birthday

Oklahoma – ~60 days from your birthday

Virginia – 60 days from your birthday (effective mid‑2025)

Recent additions / additional states:

Wyoming – effective 2025

Utah – effective 2025
(And other states are considering similar rules.)

Chuck Winslow · Answer

The Medigap "birthday rule" allows people in certain states to change their Medigap plan around their birthday each year without medical underwriting. States like California, Oregon, Idaho, Illinois, and Nevada have versions of this rule, making it easier for Medicare beneficiaries to switch to a plan with equal or lesser benefits.

Answered by Chuck Winslow on April 28, 2025

Agent Licensed in IN

Answered by Chuck Winslow Medicare Insurance Agent

Ingrid Kollmann · Answer

9 states;  California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, and Oregon.

Tony Hardwick · Answer

The 9 states with the "birthday rule" are: California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, and Oregon. This allows Medigap policy holders to switch to another plan with equal or lesser benefits within a specific timeframe around their birthday (30-63 days) without needing medical underwriting.

Answered by Tony Hardwick on April 28, 2025

Broker Licensed in GA, AL, AR & 32 other states

Answered by Tony Hardwick Medicare Insurance Agent

Kris Neupauer · Answer

California, Idaho, Illinois, Michigan, Nevada, Oregon and Washington have the birthday rule and the birthday rule means that within 30 days of your birthday, if you are on a Medigap plan, you can switch a plan to the same or lesser coverage with No underwriting—meaning they can’t deny you coverage based on health issues.

Answered by Kris Neupauer on May 1, 2025

Broker Licensed in MN, ND, SD & WI

Answered by Kris Neupauer Medicare Insurance Agent

Akia Alexis · Answer

The Birthday rule allows Medicare beneficiaries to switch their Medigap policies around their birthday each year without answering health questions. It doesn't require medical underwriting. The states with the birthday rule for 2025 are CA, OR, ID, IL, LA and NV.

Answered by Akia Alexis on August 23, 2025

Broker Licensed in GA, FL & SC

Answered by Akia Alexis Medicare Insurance Agent

Nicolas Cain · Answer

The Medigap Birthday Rule lets clients in CA, OR, ID, IL, NV, and LA switch to a plan of equal or lesser value without medical underwriting around their birthday. Missouri has a similar rule on the policy anniversary date instead.

Answered by Nicolas Cain on July 24, 2025

Agent Licensed in SC

Answered by Nicolas Cain Medicare Insurance Agent

Jason Meadows · Answer

The “birthday rule” is a state-specific Medicare Supplement (Medigap) protection that allows you to switch plans each year without medical underwriting around your birthday. This means you can change to a plan with equal or lesser benefits without being denied or charged more due to health conditions.

States that currently have some version of the birthday rule include California, Oregon, Idaho, Illinois, Nevada, and Kentucky (rules can vary slightly by state). Each state has its own timeframe—often a window starting on your birthday and lasting about 30–60 days—so it’s important to check the specific guidelines where you live.

Gary Burroughs · Answer

The Medigap “birthday rule” is a state law that gives Medicare Supplement policyholders a window around their birthday to switch to another Medigap plan without going through medical underwriting. In most states with this rule, you can move to a plan with equal or lesser benefits, often with a different insurance company, even if you have health conditions. The enrollment window is usually between 30 and 63 days, depending on the state. States that currently have some version of the birthday rule include: California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, and Wyoming.

Answered by Gary Burroughs on April 6, 2026

Broker Licensed in OR, IA, OH & SC, TX, VA & WA

Answered by Gary Burroughs Medicare Insurance Agent

Mary Rivera · Answer

It is a law in some states that lets people switch Medigap (Medicare Supplement) plans around their birthday without medical underwriting (no health questions). This helps beneficiaries change to a plan that may have lower premiums or better benefits without being denied for pre-existing conditions.
CA, ID, IL, NV, LO

Zenaida Rivera · Answer

You can switch from one Medigap plan to another without answering health questions or underwriting.

California – 60 days around your birthday to switch to a plan with equal or fewer benefits with any carrier.

Idaho – 63-day window from your birthday to switch plans/companies.

Illinois – 45 days after your birthday (ages 65-75) to change plans with equal or lesser benefits (often with same insurer or affiliates).

Maryland – 30 days from your birthday to switch to a Medigap policy with equal or lesser benefits.

Nevada – 60 days from the first day of your birth month to change plans with equal or lesser benefits.

Oregon – ~30-day window around your birthday to switch plans with equal or lesser benefits.
Kentucky – 60-day period after birthday to switch Medigap plans.

Utah – 60-day window around your birthday (effective May 2025).

Virginia – 60 days from your birthday to change plans (effective July 2025).

Wyoming – 63-day period after your birthday (effective June 2025).

Oklahoma – Many sources indicate a ~60-day birthday rule window.

Louisiana – 63 days from your birthday to switch plans (often limited to same carrier or affiliates)

Delaware – Legislation effective in 2026 establishing a birthday rule (~30 days before and after)

Tim Newsome · Answer

California, Oregon, Idaho, Nevada, Illinois, Kentucky, Maryland, Oklahoma, Kentucky, Delaware, Indiana, Louisiana, Utah, Virginia, and Wyoming all have the birthday rule. 

This rule allows for a special enrollment period window around either your birthday or in some instances around the “plan birthday” to change your Medicare Supplement policy without medical underwriting. This means no health questions and that companies cannot deny you based on pre-existing health conditions. Often limited to changing to equal or lesser coverage.

Maureen Probst · Answer

States with a birthday rule as of 2026 would be California, Delaware, Ohio, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, and Virginia


The birthday rule allows people with a Medicare supplement plan to switch to a new plan with the same plan letter with a different insurance company without any kind of health questions or medical underwriting 

There could be a few variances with what the grace period is to be eligible etc which may vary by state. It is always good to speak to a licensed broker to review your specific  state birthday rule criteria.