California Medicare Supplement Birthday Rule

The California Medicare Supplement “Birthday Rule” is a very unique Medicare Supplement rule which allows California medicare supplement members to switch companies regardless of health status.

California and Oregon are the only two states which offer the Birthday-Rule.

The Birthday Rule says; you have 60 days from the date of your birthday to change your Medicare Supplement plan to a company with the same plan or one with less benefits.  The change is guaranteed, meaning regardless of your current health status, the new California Medicare Supplement company cannot deny your application.

If you wish to “Upgrade” to a more comprehensive plan, there is a company which allows this, otherwise you will need to pass medical underwriting to upgrade.

In California there is no need to stay with a company who is charging you more than the competition.  If the benefits are the same regardless of the company you are with, you should take full advantage of this unique California law.

The Birthday Rule allows you to Change Medicare Supplement Plans on the month of your birthday.  If a person already has a Medicare Supplement plan, they have 60 days of “open enrollment” following their birthday each year when they may buy a new Medicare Supplement policy without a medical screening or a new waiting period.

The new policy must have the same or lesser benefits as the old policy.  This rule is only for Medicare Supplement (Medigap) policies.  Medicare Advantage HMO plans have different rules that apply to their annual open enrollment options. Learn more here.

You can enroll or apply for a Medicare Supplement anytime though out the year.  Although, the two best times to purchase a Medicare Supplement policy without underwriting are during the “Initial Enrollment Period” which is the six month window when you are new to Medicare Part B, or when you leave your employer health insurance plan.  The other time is during the Medicare Supplement “Birthday Rule.”  both are Guaranteed issue situations.

You can also choose not to wait for your birthday and apply for a new company at anytime during the year.  In this situation you will be asked to complete the “Health Questions” on the application, and your approval is based on your current health status.  This is also a very common event.

If you have an ongoing health condition you can apply for coverage with a different company outside of the birthday rule, simply to see if the company will approve you.  Otherwise during the month of your birthday is your best option for lowering your monthly premium.

Enrolling is easy!

Complete the appropriate company application and either fax, mail or email it back to me for processing.  I’ll make sure the process is quick and accurate with your desired effective date.

Please feel free to contact me anytime with your questions or for more information.

John Conner

John Conner

Medicare Plan Options ... Medicare Supplement, Medicare Advantage, Medicare Part D Rx