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Understanding New Medigap Rule Offerings
The “birthday rule” allows choices
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For years, Deborah Myers watched the monthly premiums climb for her Medicare supplement insurance, better known as Medigap. Myers, 76, of Roanoke County, had been enrolled in a Plan G Medicare supplement policy since she turned 65. By this year, the retired high school physics, math and computer science teacher was paying $325.79 a month.
Switching to a cheaper policy did not seem realistic. Myers has endometrial cancer that has spread to her lungs and is undergoing treatment.
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“With the cancer treatment, I was afraid I would get turned down,” Myers says.
But a new Virginia law backed by AARP Virginia gave her another option.
The law, known as the Medigap “birthday rule,” took effect July 2025. It allows Virginians who already have a Medicare supplement policy to shop once a year for another policy with the same benefits without going through medical underwriting. During the 60-day window that begins on their birthday, eligible enrollees can switch to a comparable plan offered by another insurer without being denied or charged more because of their health.
Myers used the rule this spring to move from one Plan G policy to another Plan G policy. Her new premium is $137.66 a month — a savings of about $188 a month, or more than $2,200 a year.
“I was just thrilled,” Myers says.
Medigap policies help pay some of the out-of-pocket costs that original Medicare requires, such as deductibles, coinsurance and copayments. The plans are standardized by letter, so a Plan G from one company generally offers the same core benefits as a Plan G from another company. But premiums and customer service can vary significantly.
Before Virginia changed the law, people only had one Medigap open enrollment window, during the six-month period when they first enrolled in Medicare Part B. After that, switching companies could mean answering health questions and being evaluated based on their medical history.
That left many older Virginians with little practical ability to shop for lower prices, says Jared Calfee, AARP Virginia’s state advocacy director.
“People were kind of trapped in these policies for the rest of their lives, once they made that choice,” Calfee says.
AARP Virginia pushed for the change after hearing from older Virginians who were unhappy with their provider, felt they were being overcharged or had other problems but could not easily switch, Calfee says.
Now that people can shop around each year, insurers have more incentive to keep premiums competitive and provide good customer service, giving consumers more leverage than before, Calfee says.
60-Day Window in VA
The law, passed by Virginia lawmakers in 2025, created an annual 60-day window that begins on a Medigap enrollee’s birthday. During that period, a person may apply for a policy with the same benefits offered by any insurer issuing Medigap policies in Virginia. The insurer may not deny coverage, impose medical underwriting or charge more because of health status, medical condition or claims history.
Including Virginia, 16 states have passed this type of law, and in 2027, New Mexico will join the group. New Mexico enacted the bill earlier this year, but it won’t take effect until 2027. Often called the “birthday rule,” there are variations in how each state applies the law.
In Virginia, there are limits. The rule applies to Medigap policies, not Medicare Advantage or Medicare Part D prescription drug plans. It also does not give enrollees a guaranteed right to change benefit levels. Someone with Plan G, for example, may use the rule to move to another Plan G, but not to move to a different plan letter without possible underwriting.
Current Medigap insurers must send written notice 15 to 30 days before the birthday enrollment period begins, explaining the dates of the window and the enrollee’s rights.
AARP Virginia, Calfee says, will be watching to make sure insurers are complying with the notice requirement and that the letters are clear. He says some people have reported receiving the notices; others have said they did not.
But he also says he’d heard positive feedback from people, who, like Myers, have taken advantage of the new law to save money by switching plans.
For Myers, the savings have already begun. Her new policy took effect June 1. During meetings, she has urged other retired teachers and AARP members
in her community to look into the rule when their birthdays approach.
“I’ve made an announcement at each of those for people that they should check into it,” she says.
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