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Medicare Minute: Medicare Supplements/ Medigap Birthday Month Rule

Medicare Minute: Medicare Supplements/ Medigap Birthday Month Rule

August 09, 2023

For this Blog Installment we wanted to tackle the Medicare Supplements/ Medigap Birthday Month Rule. A few key things before we begin:

  1. The Medicare supplement Birthday Month Rule only applies to someone who is currently a Medicare Supplement policy holder.
  2. This Birthday month rule is NOT available in all states – it is only available in California, Idaho, Illinois, Nevada, and Oregon. You must actively reside in one of these states.
  3. This does NOT apply to those members who have a Medicare Advantage / Part C plan.

The Birthday Rule allows you to change Medigap plans without medical underwriting. This Rule does differ slightly by those states who offer this rule, but for the most part you can typically switch and enroll in another Medicare Supplement/MediGap plan with equal or fewer benefits than your current plan – guaranteed issue!  The timeframe in which to make this change is “around” your birthday.  Again, the specific timeline for each state does differ so make sure to reach out to us if you need those details.

Question: BUT why would you switch? 

Answer: A different Insurance Carrier might have lower premiums for the exact same plan that you have currently.  Why pay more for the exact same plan – use the Birthday Month Rule to save you some $$.

Answer: A plan with “lesser” benefits may also have a dramatically reduced premium.  Allowing you to save money but still enjoy the benefits of a Medicare Supplement plan.

Our most common Birthday Month Rule Switch reasons:

  1. A particular carrier will announce higher than normal policy premium increases.  With the major carriers this is unusual, but it does happen.  This means that as a prudent buyer you should look to see if perhaps another carrier has better pricing.
  2. Medicare Supplement Plan premiums are based on your zip code and your age. Different carriers have different price points.  Some carriers will offer extremely competitive pricing when you first become eligible for Medicare but in 5 to 10 years will have much higher pricing than those other carriers who were not as competitive initially. 
  3. Medicare Supplement F plan premiums are rising dramatically. The next level plan is the G plan.  We are seeing G plan rates at substantially lower pricing than the F plan.  The only difference between the F plan and the G plan is the annual Part B deductible is applied to the G plan ($226 in 2023).  Please refer to our You Tube Presentation.  Link to the presentation: 2023 Medicare Supplement / Medigap F plan vs.  G Plan


You cannot use the Birthday Month Rule if you are enrolled in a Medicare Advantage plan.

You cannot use the birthday month rule to change your Part D Prescription Drug Plan


If you are an active Medicare Supplement / Medigap policy holder and you reside in one of the six states who offer the Birthday Month Rule you should reach out to your agent and ask them to do a review for you.  Ask for their recommendation about switching to another carrier who might offer lower premiums.  We are always available to help provide this service.  Do not hesitate to reach out.