Do you live in a state that has a Medicare Supplement Birthday Rule? If so, you may have a unique yearly opportunity to switch Medicare Supplement plans or companies WITHOUT underwriting. You may benefit and save on premiums since carrier premiums can fluctuate from year to year. Find out more information on the birthday rule, whether your state participates, and how you can benefit from making a change.
What is the Medicare Supplement Birthday Rule?
Traditionally, you have one opportunity to enroll in a Medicare Supplement plan without underwriting: during your Open Enrollment Period. If you want to change plans any time after this, carriers typically require underwriting. On the other hand, Medicare Advantage allows you to change every year during the Annual Election Period. This is because Medicare Advantage plans are regulated by the federal government. To address the unfair opportunity that Medicare Advantage enrollees have over Medicare Supplement enrollees, many states have passed legislation known as a the “Birthday Rule”. This trend has gained traction, with 14 states having enacted or proposed legislation allowing an annual Medicare Supplement change as of this article.
How the Medicare Supplement Birthday Rule varies by state
Not all state Birthday Rules are the same! They can vary based on whether they let you change plans, change insurance carriers, or both. Each of these scenarios can potentially help you save. Let’s breakdown each on to see how it can affect your premiums.
Birthday Rules that only allow you to change plans
If your state only allows you to change plans and not carriers, then this means you have to stay with the same carrier but you can pick a plan with lesser benefits. For example, if you have Plan F that has become increasingly more expensive then you can move to Plan G or Plan N to save on premiums. You do have to stay with the same carrier (or sometimes affiliates) though. This can still save you money each month even though you are giving up some coverage.
Birthday Rules that only allow you to change insurance companies
You may wonder why you would change insurance companies if you can’t change your plan. Premiums are based on several factors that can vary by company. This includes overall claims, as well as the plan risk pool. If a carrier has more claims or their risk pool is collectively unhealthy or aging, then they may offset this with higher premiums. Because of this, premiums for the same plan can vary between carriers. And this variation can change each year! Plan G with one company can be more expensive than the exact same Plan G with another company. This is why it is important to compare rates across carriers.
Birthday Rules that allow you to change BOTH your plan AND your insurance company
This scenario is really the best of both worlds. In this situation, you can change your plan, your insurance company, or both each year. However, if you change to a new plan it must be of lesser coverage. This means you can go from Plan F to Plan G, or Plan G to Plan N, or even a bigger jump from Plan F to Plan N if you want. You just cannot move up the plan chain to get better coverage without underwriting.
How can I benefit from changing plans or carriers?
Medicare Supplement premiums continue to increase year-after-year. They also fluctuate from one company to another depending on the risk pools (the group of insured beneficiaries in a plan). Fluctuation between carriers means that another carrier may offer your exact plan at a lower premium. This is one way to potentially save.
Another factor is your current plan coverage level. Some people enroll in the Medicare Supplement with the most coverage when they first turn 65 (i.e. Plan F or Plan G). This is usually due to lower initial premiums when your are younger. But as you age, premiums increase and can get expensive. This is especially true when the government discontinues a specific Medigap plan. Plan J, F, and C are discontinued plans that are getting excessively expensive because the risk pool is getting smaller and older. Switching to a different plan could lower your premium without giving up too much coverage.
States that have a Medicare Supplement Birthday Rule
Check out the chart below to see the current states with Birthday Rules. The chart details what plans you change and when for each state. This chart is accurate as of 6/23/2025. For more updated information, be sure to reach out to our licensed agents for help!
| California | Birthday Rule | You can change carriers and plans with equal or a lesser benefits as your current plan. Duration: 60 days from first day of birthday month. |
| Idaho | Birthday Rule | You can change carriers and plans with equal or a lesser benefits as your current plan. Duration: 63 days from your birthday. |
| Illinois | Birthday Rule | You can change plans with equal or a lesser benefits as your current plan. This only applies with your current carrier (or affiliates) and only applies if you are 65-75 years old. Duration: 45 days from your birthday. |
| Indiana | Birthday Rule | STARING IN 2026: You can change carriers to a plan with the same benefits. Duration: 60 days from your birthday. |
| Kentucky | Birthday Rule | You can change carriers to a plan with the same benefits. Duration: within 60 days of your birthday. |
| Louisiana | Birthday Rule | You can change plans with equal or lesser benefits as your current plan. This only applies with your current carrier (or affiliates). Duration: 63 days from your birthday. |
| Maryland | Birthday Rule | You can change carriers and plans with equal or lesser benefits as your current plan. Duration: 30 days from your birthday. |
| Nevada | Birthday Rule | You can change carriers and plans with equal or lesser benefits as your current plan. Duration: 60 days from first day of birthday month. |
| Oklahoma | Birthday Rule | You can change carriers and plans with equal or lesser benefits as your current plan, as long as there has been no gap in coverage > 90 days since intial enrollment. Duration: 60 days from your birthday. |
| Oregon | Birthday Rule | You can change carriers and plans with equal or lesser benefits as your current plan. Duration: 30 days from first day of birthday month. |
| Utah | Birthday Rule | You can change plans with equal or lesser benefits as your current plan. This only applies with your current carrier. Duration: 60 days from your birthday. |
| Virginia | Birthday Rule | You can change carriers to a plan with the same benefits. Duration: 60 days from your birthday |
States that are considering Birthday Rule legislation
The Birthday Rule is a growing trend that other states are starting to consider, many with current legislative initiatives. If you are in any of the states below, then keep an eye on your state legislation to see if it passes. Just because they are considering legislation, doesn’t guarantee it will pass.
- Wyoming
- Delaware
- Nebraska
- Iowa
- Rhode Island
What if I don’t live in a state that allows plan changes each year?
Just because you do not live in a state with a Birthday Rule, does not mean you are 100% out of luck. You can technically enroll in or change Medicare Supplement plans anytime of the year. The difference is that you would have to go through underwriting. If you are relatively healthy, then this is not an issue and you can change to a different plan or carrier to save. A licensed agent can help you determine if you have a good chance of passing underwriting. Most carriers do not require an application fee to apply and go through underwriting. If you are unsure, then pick a carrier that doesn’t have a fee to apply.
If you cannot pass underwriting but need to save money, then it may be a good time to explore other affordable coverage options. Medicare Advantage can offer affordable coverage as many plans have $0 premium. These plans still cover everything that Medicare covers, but can also include additional benefits. Learn the difference between Medicare Supplements and Medicare Advantage plans here!
Medicare can be complicated and difficult to keep up with all these rule changes! We have licensed agents in most states and can help you navigate plans. You can schedule a convenient appointment for FREE assistance here.
