About Medigap Birthday. You can listen to this article:
There is no denying that Medicare is one of the best decisions the US government has ever made for its citizens. The federal health insurance program has truly improved the state of healthcare in the country and made it more accessible to a big segment of the non-working population.
However, certain things about Medicare can be a little frustrating. Switching from one Medicare plan to another is one of them.
You just get one opportunity every year to review and change your Medicare coverage. But, this doesn’t apply to Medigap. If you have a Medicare Supplement plan, the restrictions are far more, and you don’t even get the annual open enrollment period for changing your plan.
But, it seems that the authorities have finally realized that this makes Medicare Supplement troublesome for many of the 14.5 million people who have a Medigap plan. The Medigap Birthday Rule is a step to making Medicare Supplement easier and switching plans more convenient.
What is the Medigap Birthday Rule?
The Medigap Birthday Rule is a new policy that allows the enrollees to change their Medicare Supplement plan without medical screening, underwriting, or any other condition every year around their birthday. Hence, the name.
It seems like a great initiative, but not every state offers it at the moment. Previously, the rule was only executed in two states – California and Oregon, but as of 2022, three more states are implementing Birthday Rules for Medigap beneficiaries.
The rules and regulations that govern the Medigap Birthday Rule are different in each state, and so does its duration. However, every state requires you to already be on a Medigap plan to benefit from the birthday rule; it’s not an open enrollment window for new applicants. Moreover, you also have to make sure that the new Medigap policy should have the same or lesser benefits than your existing plan.
Let’s briefly discuss how this new policy is practiced in each state to help you develop a better understanding.
States with the Medigap Birthday Rule
As of 2022, a total of five states offer the Medigap Birthday Rule, each with its own set of policies and rules governing it. Here’s a quick rundown of the most important bits of information for your reference:
1. California
California was the first state to adopt this change in Medigap policies and implement the Birthday Rule. It first came into effect here in 2010 but was revised in 2020 to extend its time duration and change some of its conditions. Currently, California allows policyholders to switch to another Medigap plan within 60 days, starting from the first day of their birthday month.
The new policy doesn’t have to be from the same insurance carrier but should have the same or lesser benefits than your existing Medigap plan.
2. Oregon
It took Oregon three years to follow California’s lead, but it was the first one to do so. The Birthday Rule came into effect here on January 1, 2013. Oregon provides the Medigap policyholders a 30-day period every year, starting from the first day of their birthday month, to change their plan. Like California, Oregon also requires that the new plan has the same or lower level of benefits.
3. Illinois
Adopting the Birthday Rule in January 2022, Illinois offers a 45-day period, starting from your birthday, to switch to another Medigap plan with the same or lower level of benefits. The new plan also has to come from the same insurance carrier that you’re currently working with, and you have to be within the age limit of 65 to 75 years to qualify for the Medigap Birthday Rule in Illinois.
4. Nevada
Nevada adopted the Birthday Rule around the same time as Illinois. But, here, you get 60 days to switch your Medigap plan, starting from the first day of your birthday month. You can also change your insurance carrier, but the new plan should have the same or lesser benefits.
5. Idaho
The last from the current lot to follow the lead, Idaho put the Medigap Birthday Rule into effect on March 1, 2022. But, it provides the longest time for changing your supplemental health insurance policy. Here, you get 63 days starting from your birthday to switch your Medigap plan. The new one can come from any carrier but should have the same or lesser benefits.
The Sum Up
Medigap Birthday Rule is a great measure to make supplemental coverage more convenient for millions of people out there. With it, you no longer have to be stuck with a not-so-great or bad supplemental plan for life. You can try out multiple plans before committing to one. The Medigap Birthday Rule also makes switching plans possible for people with pre-existing health conditions who otherwise wouldn’t pass the underwriting process.
If you live in any of the five states mentioned above and have a Medigap policy that you’re unhappy with, you can change your plan by taking advantage of the Birthday Rule. Give us a call if you are in one of the above states.