In case you didn’t know, Medigap plans can be sold year-round, and in some states, you’ll find a “Birthday Rule” that makes it easy for your clients to switch their policy, and find one that works better for them. Medigap plans are the perfect option for clients who want to choose from any doctor who accepts Medicare, without network restrictions.
About the Birthday Rule
For Medigap policyholders in certain states, (specifically California, Idaho, Illinois, Oregon, and Nevada) there is an “open enrollment” after, and sometimes just before, a member’s birthday. During this time policyholders can get a new Medigap policy without a medical screening or a waiting period. There are a few things to keep in mind regarding this “Birthday Rule.” The least of which being, the rules vary between each of the five participating states.
Keep in Mind for the Birthday Rules
- The options available to members are limited to Medicare Supplement policies (Medigap) with benefits equal or lesser than their current Medigap plan.
- For proof of plan choice eligibility, carriers may accept current Med Supp policy ID card, drivers license, or other forms of ID showing date of birth along with proof that their policy is paid to date.
- The rules are different per participating state.
The opportunity to change begins 30 days before the policyholder’s birthday and ends 60 days following.
The opportunity begins on the policyholder’s birthday and lasts for 63 days.
Medigap members who are between the age of 65 and 75 may enroll in another Medigap plan from their current carrier. The opportunity begins on their birthday and lasts for 45 days.
The opportunity begins 30 days before their birthday and ends 30 days following. This permits Oregon policyholders 61 days to take advantage of the rule.
This opportunity begins on the first day of the beneficiary’s birth month and lasts 61 days.
If you’d like to know more about Medicare Supplement plans, GI guidelines, or how they can benefit your clients, contact us for more information.