Medicare Birthday Rule States 2027: All 16 States, Their Windows and the Fine Print

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 9, 2026

A birthday rule is a state law, not a Medicare rule, so the answer to “can I switch my Medigap plan this year without health questions?” changes the moment you cross a state line. Two neighbors on the same Plan G can have very different options: one gets 63 days and any company in the state, the other gets 45 days and must stay with the same insurance group.

This hub puts every birthday-rule state on one page, built from each statute, regulation or insurance department notice rather than from other summaries. It shows how the windows differ, works out real 2027 dates for one birthday in every state and explains what to do if your state has no rule at all.

Every one of these laws does the same basic job: once a year, a person who already owns a Medigap policy can apply for a replacement and the insurer can’t use health to refuse, delay or reprice it. Where they split is the calendar. Sorting the 16 states by the day the window opens gives three groups:

Seven of the 16 rules began in 2025 or later (Utah, Virginia, Wyoming, Delaware, Indiana, West Virginia and New Mexico), so lists published even a year ago tend to be short by several states. Hawaii appears on some older summaries, but the NAIC’s May 2026 chart gives no window length, plan rule or citation for it, so we left it off.

Each row comes from the rule’s own text or the state insurance department’s guidance, checked against the NAIC chart dated May 11, 2026. “Equal or lesser” means the new policy can’t have more standardized benefits than the one you’re replacing.

*West Virginia allows any insurer only if your company and its affiliates haven’t accepted applications for the same or lesser benefits for at least 12 months. Rows shaded blue changed or began in 2026 or 2027.

The same birthday produces very different deadlines. We ran the dates for a policyholder born July 20, counting the birthday as day one, which is how Oklahoma’s insurance department tells insurers to count. Some companies count from the day after, so treat the closing dates as the earliest safe deadline, not the latest.

Most windows only require the application to arrive in time. Oklahoma’s guidance and West Virginia’s statute both say the new policy may start after the window closes, often on the first of the next month.

A window you don’t know about is worth nothing, and only some states make the insurer tell you it’s coming. Reading the notice clauses side by side shows three approaches:

In the third group, put your window dates on a calendar yourself. A state health insurance assistance program (SHIP) counselor can confirm how your state counts the days at no cost.

The second big difference is what you’re allowed to buy. Most states use an equal-or-lesser test, so a Plan G holder could move to Plan G or a plan with fewer benefits, such as Plan N. A few are tighter:

If you’re stepping down a letter, compare what you’d give up first. Our pages on Medicare Supplement Plan G and Plan N lay out the coverage gap.

Missouri is the only state that ties its yearly window to the policy, not the person. Under 20 CSR 400-3.650, if you replace your Medigap policy within 30 days of its annual anniversary, any company selling the same plan must accept you, and a renewal or billing notice proves the date. Plan changes aren’t protected, only the same letter.

New York and Connecticut sit in a different category: insurers there sell Medigap to people 65 and older without health questions in any month, so a birthday window would add nothing. Maine, Washington, Massachusetts, Minnesota and Rhode Island have their own continuous-coverage or calendar windows, which our guide to Medicare Supplement guaranteed issue rights by state covers alongside the federal rights.

Your one-time Medicare Supplement open enrollment period still gives the widest choice of any window; birthday rules are a yearly second chance, not a replacement for it.

In the other 34 states, you can still apply for a new Medigap policy any day of the year. The company will usually review Medigap underwriting questions, and a healthy applicant is often approved. If you aren’t, you keep the policy you have.

Federal guaranteed issue rights, such as your insurer going bankrupt or your Medicare Advantage plan leaving your area, apply everywhere. People who move should also check the new state’s rule: Idaho’s insurance department says newcomers get the same 63-day window, and Delaware’s rule reaches policies bought out of state by people who now live there.

For the two most-searched states in full, read the California Medicare Supplement birthday rule and the Illinois Medicare Supplement birthday rule guides.

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