California only
The California birthday rule, explained
Most states give you exactly one chance to buy a Medicare Supplement without answering health questions. California gives you one every year. It's one of the most valuable consumer protections in the country, and a surprising number of Californians who qualify have never heard of it.
What the rule actually does
- If you already have a Medicare Supplement policy, California law gives you a 60-day window that begins on your birthday each year. During that window you can switch to another Medicare Supplement policy with equal or lesser benefits, from any company, without answering health questions and without being turned down for your medical history.
- California expanded this window through legislation enacted in 2019; it had previously been 30 days.
- In practical terms: if you hold a Plan G today, you can move to another company's Plan G, or to a plan with fewer benefits such as Plan N, with no underwriting. You cannot use it to upgrade to richer benefits than you currently have.
Why it can save people money
- Medicare Supplement plans are standardized by letter, which means a Plan G from one insurance company covers exactly the same things as a Plan G from another. Benefits are identical by law. Monthly costs are not.
- Companies raise rates at different speeds. A policy that was competitively priced when you bought it five years ago may now cost considerably more than an identical policy from a different company. Without the birthday rule, switching would require passing health underwriting, which many people in their seventies and eighties cannot do.
- The birthday rule removes that barrier once a year. Same coverage, potentially lower monthly cost, no health questions.
Who it does not help
- It only applies if you already have a Medicare Supplement. If you're on a Medicare Advantage plan, the birthday rule does not let you move to a Medicare Supplement without underwriting.
- It does not apply to Medicare Advantage or Part D plans. Those change during the Annual Enrollment Period each fall instead.
- You can't trade up. Equal or lesser benefits only.
What to do with it
- Put a reminder on your calendar a few weeks before your birthday. The window is 60 days and it does not move.
- Have your current plan letter and monthly cost handy, then review what the same plan letter costs from other companies. If nothing is meaningfully cheaper, you do nothing and keep what you have. There's no penalty for looking.
- I run this review for Medicare Supplement clients every year as a matter of course, at no cost. If your current policy is still the best value, I'll tell you that.
Worth knowing: this is one of the main reasons the first decision at 65 deserves real thought. Californians who choose a Medicare Supplement get an annual no-underwriting window for life. Those who choose Medicare Advantage generally do not get a free pass back.
New to Medicare generally? Start with the plain-English guide to how Medicare works. Want to talk about your own situation? A consultation is free and there's no obligation.
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Questions about your own situation?
Call or text Justin
(916) 343-8517Monday – Friday, 9am – 6pm
Evenings and weekends by appointment
When we talk, have handy:
- Your red, white, and blue Medicare card (if you have one)
- A list of your doctors and any specialists you see
- A list of your prescription medications and dosages
- Your current plan information, if you're already enrolled
Serving Placer, Sacramento, Nevada & Yuba counties