The Medicare “Birthday Rule”: A New Way to Save on Medigap Plans in Virginia

Starting July 1, 2025, Virginia residents with Medicare Supplement (Medigap) coverage will have a new reason to celebrate their birthdays, an annual opportunity to shop around for the same Medigap coverage at potentially lower cost. This new consumer protection, known as the “Birthday Rule,” levels the playing field for Medicare beneficiaries who want better rates but have been locked into their current plan because of health history.

What the Birthday Rule Does

Each year, beginning on your birthday, you will have 60 days to switch your Medigap policy to another insurer’s plan with the same benefits. The critical piece is this: insurance companies cannot deny you coverage, charge you more, or require medical underwriting during this window.

In plain terms, your health conditions, prescription history, or pre-existing issues cannot be used against you when making a change. If you currently have Plan G, you can move to another insurer’s Plan G, no health questions asked.

Why This Matters

Until now, most Virginians faced barriers when trying to switch Medigap policies outside of their original enrollment period. A medical diagnosis, even a fairly common one, could mean higher premiums or outright rejection. The Birthday Rule breaks down that wall, giving everyone with a Medigap plan the same chance to compare options and lower costs.

For many retirees, Medigap premiums are one of the biggest ongoing health care expenses. By being able to shop the market every year, you may find another insurer offering your identical plan for significantly less. Even a modest reduction, say $50 per month, adds up to $600 per year in savings. Over ten years, that’s $6,000 back in your pocket.

What You Need to Know

• The rule only applies to Medigap policies (not Medicare Advantage).
• You can only move to a plan with the same lettered benefits (Plan G to Plan G, Plan N to Plan N, etc.).
• Your insurer must notify you 15–30 days before your birthday window begins so you know your rights.
• Your new policy will generally start the first of the month after you apply, ensuring continuous coverage.

The Bottom Line

Health care costs don’t tend to shrink in retirement, but your Medigap premiums might. The Birthday Rule gives you the power to revisit your coverage each year without worrying about being penalized for your health. That means more freedom, more competition, and more opportunities to save.