Birthday Rule States
Although Medicare is a federal program, Medigap participants in the state of California (and Oregon) benefit from state law that allows you to change your Medicare supplemental insurance without a medical subscription, provided it happens within 30 days before or after your birthday. One of the reasons the new birthday rules are complicated is that insurers and government officials have tried to give consumers the ability to change coverage without increasing the chances that some particularly generous or well-managed Medigap issuers will attract a large number of new participants with very high healthcare costs. The rule provides for a registration period open each year, which usually begins with your date of birth. In Nevada, a new birthday rule takes effect on January 1, 2022 and provides for 60-day schedule change periods that begin on the first day of a Medigap user`s birthday month. Eligible consumers can purchase new coverage with the same benefits or less, either from their existing airlines or from new airlines without medical insurance. A consumer cannot use the new rules to obtain policies with additional and innovative benefits like dental insurance, vision insurance, hearing benefits or gym memberships, officials say. The third state to add the new rule in 2022 is Idaho. Residents of the state have 63 days to switch to a plan with equal or lower benefits. In California, the rule applies to all residents who already have a medicare supplement (Medigap) policy.
The possibility of change begins 30 days before the policyholder`s birthday and ends 60 days later. Meanwhile, policyholders can switch with the carrier of their choice to a plan with the same or a lower benefit. They are not required to answer health questions – an important benefit for people with health problems. This becomes especially important when your birthday arrives every year and you have the opportunity to reassess the amount you pay for your supplemental insurance and associated coverage. This is where the birthday rule becomes important. Once you sign up for a plan on your birthday each year after that, you should review your policy to see if there are other policies available that are priced lower. There is one important rule to remember when using the birthday rule: California law states that the new policy must have the same benefits or less than the old policy. In California, insurance companies must offer the same Medicare Supplement plan coverage, but each insurance company may charge different rates for the same policy.
The new rules could also help insurance producers in affected states present Medigap`s guidelines as attractive alternatives to Medicare Advantage plans. However, there is good news for medigap policyholders in 2022. Three other states are now giving residents the option to change their plans around their birthday. This brings the total to 5 states with special Medicare anniversary rules. Many producers prefer to sell Medigap`s guidelines to consumers because they consider the rules for producers and the coverage rules for patients to be more flexible. HealthCare Inc.`s MedicareGuide consumer information and lead generation website provides a Medigap guide for a specific enrollment period that lists special birthday rule enrollment periods as well as other special enrollment dates. RetireGuide, a consumer information and lead generation website associated with senior sales in the market, has published a Medigap guide that includes a summary of the change rules for the Medigap plan. For affected health insurers issuing Medigap policies, the new rules will provide a framework for offering plan bills on a guaranteed issue basis, which may reduce the likelihood that the risks of sudden loss will result in some issuers capsizing. In Illinois, those with a Medicare Supplement (Medigap) policy who are between the ages of 65 and 75 have the option to sign up for a plan of their choice with their current airline. The performance level of the new plan must not exceed that of the current plan.
The rule provides for the special open registration window, which starts on the date of birth and lasts 45 days. In 2022, Illinois, Nevada and Idaho will offer this benefit; previously, only California and Oregon had the rule.