Medicare beneficiaries must keep the same plan type or choose one with fewer benefits. For example, a Plan F enrollee can switch to any Plan F or any other available Medicare supplement plan A-N.
Medicare supplement plans (a.k.a. Medigap plans) are designed to cover the "gaps" in Original Medicare (Parts A and B) coverage. The plans are named by letter, Plan A, B, C, D, F, G, K, L, M and N; Plans F and G have a high deductible option as well. Medigap plan benefits are standardized; in other words, each Plan F, G, etc benefits are identical, regardless of insurance company or premium charged.
In 2014 this rule was approved in Oregon to give consumers an opportunity to minimize the annual premium increases that often occur with Medigap policies. Here are some guidelines for using the Birthday Rule:
- The window of opportunity to review plan and company options begins 30 days before and ends 30 days after your birthdate.
- Applying with a new insurance company is considered Guaranteed Issue; you cannot be denied based on current or prior medical conditions.
- New coverage will begin on the first of the month following your birthdate. For example, if your birthdate is January 16th, your application date is December 21st, and your policy effective date will then be February 1st.
- Do not cancel your current Medigap policy until the new Medigap policy is issued. You may have to pay two premiums in a one-month period to ensure a smooth transfer from the old policy to the new policy.
- Switching mid-year from one Medigap High Deductible policy to another will restart the deductible under the new carrier policy. Please consider the annual deductible before changing policies.
- Switching from a Medigap Plan F to a Medigap Plan G will not require you to pay the Medicare Part B deductible if the Plan F policy already paid it to Medicare for the plan year.
- The rules that apply can be found here: OAR 836-052-0143.
- For additional information or assistance please contact CDA Insurance by phone at 541-434-9613 or by email to firstname.lastname@example.org.