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Medigap Birthday Rule States: Where You Can Switch Medicare Supplement Plans Without Underwriting

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Part of our health insurance and Medicare basics guide. Federal law gives you one Medigap Open Enrollment Period, and then it is gone. A growing group of states adds a yearly window, tied to your birthday, when people who already have a Medigap policy can change policies without answering health questions. The rules differ a lot from state to state: how long the window lasts, when it starts, and which policies you can move to.

The table below lists the 15 states whose rule we could confirm today from a state insurance department, a state SHIP or the statute itself. If your state is not listed, it may still have other protections. Check with your state insurance department or your State Health Insurance Assistance Program (SHIP) at shiphelp.org. This page is informational only; we do not sell or recommend Medigap policies.

Key takeaways

  • There is no federal annual Medigap switching window. Medicare.gov says your Medigap Open Enrollment Period "doesn't repeat every year."
  • In the states below, people who already have Medigap get a yearly guaranteed issue window around their birthday.
  • Windows run from about 31 days (Maryland) to 63 days (Idaho, Louisiana, Wyoming).
  • Some states let you move to any insurer; others limit you to your current insurer or its affiliates, or to the same plan letter.

What is the Medigap birthday rule?

It is a state law, not a federal one. Medicare.gov explains that after your one-time Medigap Open Enrollment Period, insurers can "deny you a policy if you don't meet their medical underwriting requirements," unless you have a guaranteed issue right. It also tells readers to check with their state because "you may have additional rights under state law."

A birthday rule is one of those state rights. If you have a Medigap policy on your birthday, the state gives you a window each year to buy a replacement policy without the insurer denying you, or charging you more, because of your health. Every state in the table whose source spells out the plan rule limits the move to a policy with the same or fewer benefits, so you can trade across or down, not up. Wyoming's department summary does not say which plans qualify.

Which states have a Medigap birthday rule?

StateWindowWhat you can switch toOther limitsSource
California60 days following your birthdayA policy with the same or lesser benefitsCA Department of Insurance
DelawareStarts 30 days before your birthday, lasts at least 30 days afterSame or lesser benefits, from your current or a different carrierPolicy bought in Delaware, still living there; effective January 1, 2026Delaware Department of Insurance
Idaho63 days starting on your birthdayA plan of similar or lesser benefitsIn effect after February 28, 2022Idaho Department of Insurance
Illinois45 days starting on your birthdayEqual or lesser benefits, with the same insurer or an affiliateAges 65 to 75 only215 ILCS 5/363
IndianaWithin 60 days of your birthdayThe same plan letter at another companyStarts January 1, 2026; age 65 or olderIndiana SHIP
KentuckyWithin 60 days of your birthdayThe same plan, from a different insurerEffective January 1, 2024KRS 304.14-525
Louisiana63 days starting on your birthdayEqual or lesser plan letter, from the same issuer or an affiliateLouisiana Revised Statutes
MarylandYour birthday and the 30 days afterEqual or lesser benefits; you do not have to stay with your current carrierPolicies issued in Maryland; since July 1, 2023Maryland Insurance Administration
NevadaStarts the first day of your birthday month, at least 60 daysSame or lesser benefits, from your existing or a new carrierEffective January 1, 2022Nevada Division of Insurance
Oklahoma60 days starting on your birthdaySame or lesser benefits, regardless of current issuerNo coverage gap over 90 days since first enrollingOklahoma Insurance Department
Oregon30 days before to 30 days after your birthdayThe same plan type or one with lesser benefits, from any companySelf-funded employer group Medigap plans not eligibleOregon SHIBA
UtahYour birthday through 60 days laterA comparable or lower-tier plan offered by your current issuerUtah Code 31A-22-620
Virginia60 days starting on your birthdayThe same benefits (for example Plan G to Plan G), from any insurer in VirginiaSince July 1, 2025Virginia Bureau of Insurance
West VirginiaFirst day of your birthday month to 60 days laterSame or less, from your insurer or an affiliatePolicy in force 24 months; applies to policies issued or renewed on or after June 1, 2026WV Insurance Commissioner
Wyoming63 days starting on your birthdayAlternative Medigap plans, no medical underwritingImplemented in 2025Wyoming Department of Insurance

Accessed October 1, 2026. Blank cells mean the source we used did not state an extra limit, not that none exists. Confirm details with your state before you apply.

How do the windows line up with your birthday?

The start date trips people up more than the length. There are three patterns.

Three birthday rule timing patterns: starts before the birthday (Delaware, Oregon), starts on the first of the birthday month (Nevada, West Virginia), tied to the birthday itself (California, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Oklahoma, Utah, Virginia, Wyoming); Indiana and Kentucky say within 60 days of the birthday When the window opens Your birthday Before the birthday: Delaware, Oregon 30 days before + 30 after First of birthday month: Nevada, West Virginia 60 days from the 1st From the birthday: the other 11 states* 31 to 63 days after
Timing patterns from each state's source in the table above. Bar lengths are schematic; Maryland's window (birthday plus 30 days) is the shortest and Idaho, Louisiana and Wyoming (63 days) the longest. *Indiana and Kentucky say "within 60 days" of the birthday without fixing the start; confirm with the state.

Can you switch to any Medigap plan during the birthday window?

Usually not. Read the "What you can switch to" column carefully, because it decides whether the rule helps you.

Maryland adds a pricing detail worth knowing: policyholders who were underwritten and got less than the preferred rate "are entitled to the preferred rate during the guaranteed issue period."

Practical tip from Oregon: Oregon's fact sheet says not to cancel your current Medigap policy "until the new Medigap policy is issued," and warns you may pay two premiums for one month to avoid a gap. That advice holds in any state.

Does the birthday rule help if you are in Medicare Advantage?

Generally no. These rules apply to people who already have a Medigap policy. If you are in Medicare Advantage and want to move to Original Medicare with Medigap, the federal trial rights and annual Medicare enrollment periods are the relevant rules. Our comparison of Medigap vs Medicare Advantage basics explains them.

Delaware is one state that addresses this separately. Its insurance department says the same law (SB 71) bars Medigap insurers from denying applications from people switching from Medicare Advantage, though insurers may individually rate them and apply a pre-existing condition limitation.

How do you use a birthday rule window?

  1. Confirm your state's rule with your state insurance department or SHIP, using the source links below.
  2. Write down your exact window. Note whether it starts before your birthday, on the first of the month or on the birthday itself.
  3. Check what you can move to. Same letter, same or lesser benefits, or same insurer only.
  4. Compare premiums for the plans you are allowed to buy. Medicare.gov says plans with the same letter offer the same basic benefits, so price is the main difference.
  5. Apply inside the window and keep your current policy until the new one is issued.

If you are not on Medigap yet, your most important window is the one-time federal Medigap Open Enrollment Period. Our Medicare enrollment timeline for turning 65 explains when it starts.

FAQ

Is there a federal Medigap birthday rule? No. Federal law gives a one-time 6-month Medigap Open Enrollment Period. Medicare.gov says it "doesn't repeat every year." Birthday rules come from state law.

Can I upgrade from Plan N to Plan G during a birthday window? Not under the rules listed here. Every state whose source spells out the plan rule limits the guaranteed move to the same or lesser benefits, or to the same plan; Wyoming's summary does not say, so ask its insurance department. An upgrade would usually go through medical underwriting.

Does Illinois's rule apply at age 80? No. 215 ILCS 5/363 limits it to people at least 65 and no more than 75 years old.

Can the insurer raise my price because of my health during the window? Each source in the table describes the qualifying switch as guaranteed or free of medical underwriting. The Illinois and Louisiana statutes also say the insurer cannot discriminate in pricing because of health status. Indiana's SHIP notes premiums can still vary by age, gender, ZIP code and tobacco use.

My state is not in the table. Do I have any options? Possibly. Federal guaranteed issue rights apply in some situations, such as losing other coverage, and your state may have other protections. Ask your SHIP or state insurance department.

Sources

This page is general information, not insurance, legal or enrollment advice. FinanceRazor does not sell or recommend Medigap policies or insurers. State rules change; confirm with your state insurance department or State Health Insurance Assistance Program before you act.