State Specific GI Rules

Birthday Rule: CA, ID, IL, KY, NV, OK, OR, LA, MD, UT

• CA – 91-day open enrollment window which starts 30 days before their birthday and ends 60 days following. During this time, policyholders can change to any plan of equal or lesser benefit with the carrier of their choice.
• ID – 63-day guaranteed issue period beginning on the beneficiary’s birthday and allows them to enroll in any plan of equal or lesser benefit with any carrier.
• IL – Allows beneficiaries between the age of 65 and 75 the chance to enroll in a plan with their current carrier. The new plan’s benefit level must not exceed that of their current plan. This open enrollment window opens on their date of birth and lasts 45 days.
• NV – 61-day open enrollment window opens on the first day of the beneficiary’s birth month. During this time, policyholders can change their Medigap carrier or plan if it is an equal or lesser benefit to their current plan.
• OK- 60-day open enrollment window beginning on birthday, allows you to change to any carrier or plan of equal or lesser benefit with no health underwriting.
• OR – 31-day open enrollment period to change to any carrier or plan of equal or lesser benefit with no health underwriting. The rule begins on your date of birth and ends 30 days following.
• KY- 60-day open enrollment period, beginning on an individual’s birthday where they can purchase the same Medicare supplement they currently have with a different insurer.
• LA- 45-day open enrollment beginning on beneficiary’s birthday to any carrier or plan of equal or lesser benefit with no health underwriting if the individual is at least 65 years of age.
• MD- 30-day open enrollment period to change to any carrier or plan of equal or lesser benefit with no health underwriting. The rule begins on your date of birth and ends 30 days following.
• WY: 63- day open enrollment beginning on the insured’s birthday
• VA: 60- day open enrollment beginning on the insured’s birthday to the same or lesser benefits. Innovative benefits not considered when determining.
• UT: 60- day open enrollment beginning on the insured’s birthday. Same company required equal or lesser benefits.

Year-Round Open Enrollment: CT,NY, VT, WA

• *Vermont – OE for Mutual of Omaha and UnitedHealthcare only, all other carriers will go through medical underwriting.
• *Washington- Year-round OE for any plan (but if they have Plan A they only have GI to go into another Plan A)

Annual Guaranteed Issue: MO, ME

• Missouri – Policyholders may enroll into like benefits with another carrier beginning 30 days before the annual policy anniversary and ending 30 days after.
• Maine – Open Enrollment for Plan A is carrier specific. Policyholders may change their Medigap plan to another policy of equal or lesser value.

Voluntary Group Termination

Generally, choosing to leave your health care coverage will not land you in a guaranteed issue situation. You CAN use guaranteed issue rights to change from employer coverage to Medigap coverage in the following states (may need to meet certain criteria for some):

AK, AR, CA, CO, FL, ID, IL, IN, IA, KS, LA, ME, MO, MT, NV, NJ, NM, OH, OK, PA, SD, TX, VA, WV, WI

Medigap Plans for Those Under 65 on Disability

TX: Starting September 1, 2025, an individual with ESRD or ALS who becomes eligible for Medicare before age 65 must be offered the same coverage offered to those 65 and older, at the same rates for plans A, B and D. No medical underwriting, waiting period or preexisting condition limitation may be imposed. The enrollment opportunity begins for anyone eligible from December 1, 2025.

Federal law does not require carriers to sell Medigap to people under 65. Still, some states require companies to sell Medigap, even if the beneficiary hasn’t had their 65^th birthday yet. Those living in states that don’t require carriers to provide a Medigap plan option to those under 65 may still have some options.

The following states DO NOT require Medigap options for those under 65:

AL, AK, AZ, AR, ID, IN, IA, NE, NV, NM, ND, OH, RI, SC, UT, VA, WA, WV, WY

Loss of Medicaid Eligibility

There’s a 63-day GI window after loss of Medicaid benefits in the following states:

CA, CO, KS, TX, ME, MT, OR, TN, UT, WA, WI