Do you live in one of these 5 states?
- California
- Oregon
- Missouri
- Idaho
- Nevada
If no, kindly skip to Fact #4.
The “Birthday Rule”
Up until 2022, only 3 states, California, Oregon, and Missouri had a consumer protection in place for existing policy holders called the “Birthday Rule.”
Nevada and Idaho adopted similar state legislation effective 2022.
The “Birthday Rule” allows you to keep your existing Medicare Supplement plan and identical great coverage, while switching to the most competitively priced company.
This rule allows a 60-day time period each year for you to change your company and keep your same plan, same doctors and same great coverage.
The only thing that changes is the rate you pay each month.
Often the savings are $40.00-$120.00 per month for a couple.
Underwriting is not required.
Underwriting is the process in which an insurance company assesses each individual applicant based on current and prior health conditions. The company then decides which people to accept and which people to decline.
In most states, this means that only the healthiest of applicants are permitted to change companies for one with a better rate.
This process allows the insurance companies to basically charge whatever rates they choose and leaves those people with existing health conditions without another option.
You cannot be denied access to the best rate.
For example:
Client with a 5-15-1953 birthday and is currently undergoing cancer treatments. The client is covered by a Medicare Supplement "Plan G".
Client lives in one of the five states and takes advantage of the birthday rule. The new policy with the most competitive company has an effective date 6-1-2023.
All treatments up until midnight of 5-31-2023 will be paid by the prior company and all treatments on 6-1-2023 and after will be covered by the replacement company.
States with specific birthday rules:
New in 2022
Nevada –
The Nevada birthday rule gives you a guaranteed issue period of 60 days which starts on the first day of your birth month.
Idaho The rule, IDAPA 18.04.10, was published November 3 in the Administrative Bulletin Volume 21-1
- Medicare Supplement policyholders may change their insurance company and/or plan annually regardless of health conditions during a 63-day enrollment period beginning on the policyholder’s birthday; and
- Premium rates for new Medicare Supplement policies (including when changing insurance companies) will no longer be based on the age of the applicant. This is referred to as “community rating.”
California
California –
The California birthday rule gives you a guaranteed issue period of 60 days from the first day of your birthday month.
Missouri
Missouri –
If you have a Medigap policy, The Missouri “Anniversary Rule” authorizes you to change companies within 30 days before and 30 days after your Initial Enrollment anniversary.
Oregon
Oregon –
The Oregon birthday rule gives you a guaranteed issue period of 30 days before and 30 days after your birthday.