Illinois Birthday Rule for Medicare Supplement Plans

Effective January 1, 2022, Illinois will be implementing a birthday rule for Medicare Supplement policyholders. This means that all Medigap beneficiaries residing in the state will have an annual opportunity to change their Medigap plan, without needing to undergo medical underwriting and answer health questions. We’re here with all the information you need about this new rule!

New Illinois Birthday Rule for Medigap Plans

Each year, Illinois Medigap recipients between the ages of 65 and 75 will have a chance to change their current Medigap plan. The new policy must be of equal or lesser benefit. Additionally, the new policy must be from the same carrier.

The time during which this change is possible is a 45-day window that the Illinois birthday rule provides. Starting on their date of birth, people with existing Medigap plans may make such changes without the need for medical underwriting. This rule allows policyholders to review their coverage when they may not otherwise face denial from a plan due to pre-existing health conditions.

Outside of this timeframe, the application would require underwriting health questions unless the individual qualifies for guaranteed issue rights. Thus, they could face denial due because of their health history.

At this time, beneficiaries may not make the change from a Medicare Advantage plan to Medigap. Again, this rule only applies to those who already have Medigap.