Medigap Birthday Rule

Christian Worstell
In this article...
  • Learn about the Medigap birthday rule, which lets Medicare Supplement policyholders in California, Oregon, Idaho, Illinois and Nevada reevaluate their plans.

If you are currently enrolled in a Medicare Supplement plan, you may have heard of the Medigap birthday rule. This rule gives some policyholders the ability to adjust their policies and coverage on a more frequent basis, but it's not available to everyone.

Read on to learn more about the Medigap birthday rule and the specific guidelines in each state that offers it.

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

What Is the Medigap Birthday Rule?

Many Medicare policyholders across the nation don't have the chance to update, customize or adjust their plan or provider without being subjected to a barrage of preliminary screening questions.

However, five states have the Medigap birthday rule, which gives Medicare Supplement policyholders the annual opportunity to make changes to their current Medigap coverage without having to answer the mandatory questions that typically accompany such adjustments. 

This adjustment period coincides with a policyholder's birthday — hence the rule's name — and usually lasts for a duration of anywhere from 1 to 3 months. The five states that have the birthday rule are California, Oregon, Idaho, Illinois and Nevada.

How Does the Birthday Rule Differ by State?

Each state has slightly different timelines and requirements for the birthday rule.

1. California

California's open adjustment period spans 3 months, beginning 30 days before a policyholder's date of birth and ending 60 days after it. 

2. Oregon

Oregon allows its policyholders to change or switch from plan to plan, or even provider to provider, with no underwriting at all. However, there's a catch: You can only switch to a new plan of equal or lesser value than your current one. Also, the adjustment period in Oregon is only available for 30 days after your birthday.

3. Idaho

Idaho allows policyholders to change from any current plan to a new one of equal or lesser value. The adjustment period lasts for 63 days beginning on the policyholder's birthday. 

4. Illinois

In Illinois, only Medigap beneficiaries between the ages of 65 and 75 are eligible to change coverage under the birthday rule. Policyholders can enroll in any new plan of equal or lesser value, but it must be from their current provider. The adjustment period starts on the person's birthday and lasts 45 days.

5. Nevada

In Nevada, the rule's grace period opens on the first day of your birth month and continues over the following 61 days. Policyholders can switch to any new carrier or plan of equal or lesser value.

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

Does the Birthday Rule Apply to Original Medicare or Medicare Advantage Plans?

Original Medicare and Medicare Advantage plans do not offer the same birthday rule as Medigap. However, it's still possible to change your coverage if you're not happy with it.

If you change your Original Medicare or Medicare Advantage plan, you typically don't have to go through the health screenings in order to apply for coverage.

Learn more about how the Medigap birthday rule may or may not affect your eligibility. Compare Medicare Supplement plans where you live and get help applying for a plan from a licensed insurance agent.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at

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