Dear AMAC,
I recently received a letter stating that Maryland has passed legislation called “Birthday Rule”, but I want to make sure I am understanding it correctly. What is the Birthday Rule and how will this affect my Medicare?
–Leslie, Bel Air, MD
Hello Leslie,
There are several states in the US that already have expanded rights for their Medicare beneficiaries such as a Birthday Rule. The Birthday Rule gives those that already have a Medicare Supplement (aka Medigap) the opportunity to make changes to their plan during a timeframe that surrounds their birthday each year.
California, Idaho, Illinois, Nevada, Oregon, and Louisiana already have their own versions of the Birthday Rule in place. The Birthday Rule prohibits Medicare Supplement carriers from imposing medical underwriting on applicants during a short window of time that surrounds their birthday. However, each of these states has different stipulations as to when you can use it and which plan letter you can purchase.
At the beginning of 2023, Maryland signed House Bill 247 into law, which is also known as the Birthday Rule. This new law will require Medicare Supplement carriers to allow anyone who already has a Supplement to change into a new plan of equal or lesser coverage without going through medical underwriting within 30 days of that individual’s birthday.
This will begin with anyone who has a birthday July 1st, 2023, and after. If your birthday already passed this year, you would have to wait until next year to use the Birthday Rule Open Enrollment.
This means that if you have significant health issues like cancers or heart disorders, you have a new opportunity to make plan changes that you wouldn’t have had otherwise. If you have ever been told you weren’t eligible to switch plans due to your health history, then this is a huge win for you! Using the Birthday Rule will guarantee your acceptance into a specific plan. But make sure you are using it wisely.
For example: If you have a Plan G, you can switch over to another Plan G through a different carrier, or a plan that covers less, like Plan N. If you try to go from Plan N to Plan G, you WILL have to answer health questions because you would be going into a plan with more benefits. Also, be sure you apply for your new Medicare Supplement within the 30-day period after your birthday. If you are just one day late, you will have missed your eligibility window.
For most people, the Open Enrollment Period ends 6 months after Medicare Part B has started. But if you live in any of the above-mentioned states, the Birthday Rule gives you an additional opportunity to make changes without the carrier looking into your health history.
There are more states that offer additional Medicare protections like a Guaranteed Issue that’s based on your policy’s anniversary date in the state of Maine and Missouri, and a year-round Open Enrollment opportunity in the states of New York, Vermont, Washington, and Connecticut. Of course, the rules work differently in each of these states, so be sure to check with a licensed Medicare advisor to understand the rules in your state and be sure you qualify.
For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below!
