What states have the Medigap "birthday rule" and what is it?
Answered by 8 licensed agents
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!
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.
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.
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.
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)
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.
