Idaho Birthday Rule for Medigap Policies

Beginning March 1, 2022, Idaho will be implementing a birthday rule for Medicare Supplement plans. This means that each year, all Medicare Supplement policyholders residing in the state will have a guaranteed issue window, opening on their birthday, to change carriers or plans. Below, we explain the details you need to know before making changes to your coverage.

New Birthday Rule for Medicare Supplement Policies in Idaho

Once the birthday rule is in effect, you will be able to make changes to your plan each year with no health assessment. The Idaho birthday rule provides a 63-day window for changes, starting on your date of birth.

Policyholders can utilize this rule to change to a Medigap plan that provides equal or lesser benefits than their current plan. For example, one would not be able to change from Plan N to Plan G, as Plan G provides more benefits. Additionally, policyholders may also change carriers at this time if their new plan still meets the rule’s equal-or-lesser stipulation.

The Idaho birthday rule allows for an exception. Thus, a policyholder who may not pass carrier-specific health questions can enroll in any qualifying plan (of equal or lesser benefits).

This birthday rule only applies to those who have been accepted to a Medigap plan before their birthday. A beneficiary may not change from an Advantage plan to a Medigap plan at this time. Additionally, they cannot use the birthday rule to obtain a Medigap plan for the first time.

Also, note that premiums for new Medigap policies in Idaho will use the community rating method. Most policies in the state were previously rated using the issue-age method, but that will be changing for 2022 and beyond.