Medigap Birthday Rules by State (2025): Switch Without Underwriting

Why Medigap Birthday Rules Matter

Switching Medicare Supplement (Medigap) insurance can be challenging once your initial enrollment ends. After the Medigap open enrollment period, most states allow insurers to require medical underwriting, which may result in higher premiums or even denial of coverage for those with health conditions.

That’s where Medigap birthday rules come in. These consumer protections allow Medicare beneficiaries to switch Medigap plans without underwriting, typically once a year around their birthday.

If you’re weighing your coverage path, understanding the tradeoffs between Medicare Advantage vs. Medigap can help you choose the best option for your healthcare needs.

What Is the Medigap Birthday Rule?

The Medigap birthday rule allows you to change Medicare Supplement plans each year during a short window tied to your birthday—without medical questions or denial due to pre-existing conditions.

• Guaranteed issue rights: Applications must be accepted.

• Plan restrictions: Most states limit switching to plans with equal or lesser benefits.

• Timeframe: Depending on the state, your window lasts 30–63 days.

• Carrier rules: Some states let you change carriers, while others limit you to the same insurer.

For example, many people compare Medigap Plan G because it balances comprehensive coverage with moderate premiums.

Medigap Birthday Rules by State (2025)

Here’s a summary of states offering Medigap switching rules in 2025.

A few states offer even stronger protections. New York Medicare Supplement plans, Vermont Medigap plans, and Connecticut Medicare Supplement options allow year-round switching without underwriting.

Other states, like Maine and Oklahoma, have continuous coverage protections. Washington allows year-round plan-to-plan switching under specific rules.

Benefits of Switching Medigap Plans

Birthday rules provide:

• Freedom to shop for lower-cost plans annually.

• Flexibility to adjust coverage if your health needs change.

• Consumer protection since insurers must accept eligible applications.

If you’re unsure which option best fits, working with a licensed Medicare insurance agent can simplify the process.

What If Your State Doesn’t Have a Birthday Rule?

Even if your state doesn’t have birthday protections, there are still opportunities:

• Continuous guaranteed issue states: CT, NY, VT allow switching anytime.

• Maine and Oklahoma: Offer protections for those with continuous coverage.

• Washington: Allows certain plan-to-plan changes year-round.

• Medicare Advantage: During the annual open enrollment (Jan 1 – Mar 31), you can return to Original Medicare and apply for Medigap (switching from Medicare Advantage to Original Medicare).

For a broader context, some states also rank among the best states for elderly healthcare, offering stronger benefits and protections.

FAQs: Medigap Birthday Rule

Can I upgrade to a better Medigap plan under the birthday rule?
Usually, most states only allow switching to equal or lesser coverage. Some, like Utah and Wyoming, permit “similar” benefits.

How long is the Medigap birthday window?
Depending on the state, your guaranteed issue period lasts 30–63 days from your birthday.

Can I switch Medigap anytime?
Only in states with unlimited open enrollment, like Connecticut, New York, and Vermont. Otherwise, you must wait for your birthday rule or another Medicare supplement special enrollment period.

Action Steps to Use the Medigap Birthday Rule

1. Mark your birthday window (30–63 days depending on your state).

2. Compare plan options—many cost-conscious seniors consider Medigap Plan N for its lower premiums.

3. Request quotes from multiple carriers (if allowed in your state).

4. Apply before your window closes to lock in guaranteed issue rights.

Bottom Line

The Medigap birthday rule gives Medicare beneficiaries a powerful tool: the chance to switch Medigap plans without underwriting. If your state offers it, you gain annual flexibility to lower costs and keep your coverage aligned with your health needs.