Page 43 - Appendices to Donald Pender's Evaluation

7/2/2021 Medigap's "Birthday Rule" is Extended to 60 Days - California Health Advocates
How does it work?

If you already have a Medigap plan, you can choose a plan from any company, but are limited to
one that has the same or fewer benefits than your current plan. For example, if you already have

Plan C, you may switch to another Plan C, but not to a Plan G. Note that companies can offer you a
plan with more benefits if they choose, but they are not required to do so.

Also, additional or “innovative benefits” that some companies add to one or more of the

standardized Medigap plans may not be consider greater benefits than the same lettered plan
without those “innovative benefits”. This means that, for example, if you have Medigap Plan F with
company X and want to switch to Medigap Plan F with company Y that has also added some

innovative benefits to their Plan F, you by law must be allowed to make that switch. (Note that if you
buy one of those plans with extra benefits, you should see a separate line item for the cost of those
extra benefits on your Medigap premium bill.)

We have already heard some cases of beneficiaries being denied this right. If that happens, please

contact your local Health Insurance Counseling and Advocacy Program (HICAP) for assistance at 1-
800-434-0222.

For more information, view our Medigap section online.

Filed Under: Medicare & Other Health Insurance

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About Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical

expertise, writing and research on Medicare, health disparities and other health care
issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer
and consultant. See her current articles.

https://cahealthadvocates.org/medigaps-birthday-rule-is-extended-to-60-days/#:~:text=If you live in California,for at least 60 days. 2/5