Medigap

Medigap eligibility.

Your six-month Medigap Open Enrollment Period starts the month you turn 65 and are enrolled in Part B. During that one-time window, every Medigap insurer in your state must sell you any plan they offer at the same price as a healthy applicant — no medical underwriting, no health questions, no denial. Outside that window, most states let insurers deny you or charge more based on health. California is an exception: the Birthday Rule keeps a 60-day annual window open every year.

The one window where you have full rights

Your Medigap Open Enrollment Period is a 6-month window that begins the month you turn 65 and are enrolled in Part B. During this window:



• You can buy any Medigap plan available in your state
• The carrier cannot ask about your health
• The carrier cannot deny you
• The carrier cannot charge more for pre-existing conditions

This is the cheapest, easiest time to enroll. Miss it, and the rules change.

Outside Open Enrollment — underwriting applies

Once your 6-month window closes, carriers can do medical underwriting:



• Ask detailed health questions
• Pull your prescription history
• Deny coverage entirely
• Charge a higher premium
• Impose a 6-month waiting period for pre-existing conditions

People in good health can usually still get a plan, but it's no longer guaranteed and the price is no longer the lowest.

Guaranteed-issue rights

Outside your initial OEP, you can still buy Medigap without underwriting in certain "guaranteed-issue" situations:

• Your employer retiree health plan ends
• Your Medicare Advantage plan leaves your area or ends
• You move out of your MA plan's service area
• You join an MA plan when first eligible at 65 and disenroll within the first 12 months ("trial right")
• Your Medigap insurance company goes bankrupt
• You're misled by the plan



Each guaranteed-issue right has tight time windows—usually 63 days from the qualifying event.

California's annual extra window — the Birthday Rule

California is one of a handful of states that gives every Medigap holder an annual 60-day window starting on their birthday to switch to another Medigap plan with equal or lesser benefits—without medical underwriting.



Full details on the CA Birthday Rule →

Disability under 65

Federal law doesn't require carriers to sell Medigap to people under 65. California, however, requires it. Premiums for under-65 Medigap in California are typically much higher than for 65+ folks—but having access at all is a meaningful right.

Don't lose your window

If you're approaching 65 and are even considering Medigap, talk to a broker before your 6-month OEP closes. The price difference between OEP and post-OEP enrollment can be hundreds of dollars per month for life.

Talk to a licensed agent—no cost, no pressure.

30-minute call. We'll review your situation, compare plans available in your area, and answer your questions. No obligation, ever.