If you’re enrolled in a Medicare Supplement (also called Medigap) plan, there’s some good news for you! Six new states have recently adopted the Birthday Rule, and Michigan is currently considering similar legislation.
This rule allows policyholders to switch Medigap plans around their birthday without underwriting…the risk assessment process an insurer uses to evaluate a potential policyholder’s risk and decide whether to issue coverage and at what price. This makes it potentially less challenging to find coverage or pricing without worrying about your health status.
What Exactly Is the Birthday Rule?
The Birthday Rule is a state-specific Medigap provision that allows existing Medigap (Medicare Supplement) policyholders in certain states to change to a new Medigap plan around their birthday without having to undergo medical underwriting or answer health questions. These rules vary significantly by state, with some offering a short window for switching to similar or less-beneficial plans, while others provide more extensive protections, making it crucial for individuals to understand their specific state’s regulations.
What Does it Mean for You?
Enaction of the Birthday rule re: Medigap means:
- No denial due to pre-existing conditions
- No rate hikes based on health status
- A chance to shop for better service or pricing annually
Where is it Available?
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 Medigap plan of equal or lesser benefits without needing medical underwriting around their birthday. State-specific regulations dictate the exact length of the enrollment window and the types of plans you can switch to.
Why Does it Matter?
Healthcare costs are a major part of retirement planning, and the Birthday Rule gives consumers more control. It’s especially helpful for those who:
- Have developed health conditions since enrolling
- Want to switch carriers for better service
- Are looking to reduce premiums
If you’re exploring Medigap options, our Medicare Medigap Plans Explained blog can help you understand the differences between plans.
Want More?
You may be interested to read our blogs about Medicare below to deepen your understanding:
- When Should I Enroll in Medicare Part B? – Timing tips for Medicare enrollment.
- 7 Things You Should Do When You Turn 65 – A checklist for Medicare newcomers.
- What Is Supplemental Health Insurance? – Learn how to protect your budget from unexpected medical costs.
The expansion of the Birthday Rule is a win for Medicare Supplement policyholders. It empowers consumers to make smarter choices about their coverage—without the fear of being denied due to health. Whether you’re an agent or a retiree, understanding this rule can help you make the most of your Medicare options.
We’re here for you!
Bankers Life is here to help customers with their financial and insurance needs so please visit us at BankersLife.com to learn more.
Bankers Life is not affiliated with or endorsed by the U.S. government or the federal Medicare program.
