What is the California “Birthday Rule”?

The California “birthday rule” is an annual “open enrollment” period available to California residents during which they can change their Medicare Supplement plans. This open enrollment period is specific to CA residents – most other states don’t have this stipulation.

Below, I’ve listed some important criteria/things to remember about the CA “birthday rule” and how it works:

  • To be eligible to use this open enrollment period, you must already have a Medigap plan.
  • You can switch to another plan, as long as it is of equal of lesser coverage level. In other words, if you have Plan F (the top level of coverage), you can switch to any plan with any company. If you have one of the lower level plans (Plan N, for example), you would have to stay with the plan that you have. NOTE: This is somewhat more of an incentive to take a higher level plan when you are first eligible for Medicare, as it could be difficult to go “up” in coverage later.
  • Keep in mind that you can change Medigap plans at any time of the year. There is not a restriction on WHEN you can change, just HOW the change takes place. If you change outside of your “birthday rule” open enrollment, you would have to qualify medically (i.e. answer medical questions, etc.). During the annual “birthday rule” open enrollment, though, you do NOT have to answer medical questions when you change plans.
  • The time period for this annual open enrollment period is 30 days following your birthday. So you can apply at any time (up to 30 days) leading up to your birthday extending through 30 days after your birthday, but the policy must take effect on your birthday or in the 30 days after your birthday.

To reiterate, this “birthday rule” is specific to California residents and existing Medicare Supplement policyholders. For more information about California Medicare Supplement plans, visit California Medigap or call us at 877.506.3378.