Medigap Open Enrollment and Guaranteed Issue Rights
Medigap insurers can usually ask about your health, charge more or say no. The exceptions are your one-time Medigap Open Enrollment Period, a short list of federal guaranteed-issue situations, and extra rights some states add. Miss them and you may not get the policy you want later.
Your Medigap Open Enrollment Period
It lasts 6 months and starts the first month you have Medicare Part B and are 65 or older. It’s a one-time window: it doesn’t repeat every year, and it can’t be moved once it starts. During it, you can:
- Buy any Medigap policy sold in your state, from any insurer licensed there. The insurer can’t turn you down or use medical underwriting.
- Pay the same premium as people in good health. The insurer can’t charge more because of health problems.
- Have coverage start right away, apart from a possible pre-existing condition wait: up to 6 months for a condition treated or diagnosed in the 6 months before the policy starts. That wait is shortened or removed if you had creditable coverage with no break longer than 63 days.
Still working at 65? If you have group coverage through your or your spouse’s current job, you may be able to delay Part B without a penalty. Because Medigap Open Enrollment starts with Part B, delaying Part B also delays the window until you actually need Medigap. Retiree coverage and COBRA don’t count as current employment. See Medicare enrollment periods and the turning-65 checklist.
Under 65? Federal law doesn’t require insurers to sell Medigap to people under 65 with Medicare because of a disability or End-Stage Renal Disease. You still get your Medigap Open Enrollment Period when you turn 65. 37 states require insurers to offer at least one Medigap policy to people under 65 (list below).
Federal guaranteed-issue rights
In these situations an insurer must sell you a policy, must cover pre-existing conditions with no waiting period, and can’t charge more for your health. People new to Medicare on or after January 1, 2020 get Plan D or G wherever the right lists Plan C or F.
| You have a right if… | You can buy | When to apply |
|---|---|---|
| Your Medicare Advantage plan leaves Medicare, stops serving your area, or has a significant network change, or you move out of its service area, and you go back to Original Medicare | Plan A, B, C, D, F or G sold in your state | From 60 days before your Advantage coverage ends (or the date on your plan’s termination notice) to no more than 63 days after it ends |
| You have Original Medicare plus employer, retiree, COBRA or union coverage that pays after Medicare, and that coverage is ending | Plan A, B, C, D, F or G sold in your state | No more than 63 days after the latest of: the date coverage ends, the date on the ending notice, or the date on a claim denial |
| You move out of your Medicare SELECT policy’s service area | Plan A, B, C, D, F or G sold in your state or the state you’re moving to | From 60 days before to 63 days after the SELECT policy ends |
| Trial right: you joined a Medicare Advantage plan or PACE when first eligible for Part A at 65, and within the first year you want Original Medicare | Any Medigap policy sold in your state | From 60 days before to 63 days after that coverage ends |
| Trial right: you dropped Medigap to join Medicare Advantage (or switch to SELECT) for the first time, have been in it less than a year, and want to switch back | Your old Medigap policy if the same insurer still sells it; otherwise Plan A, B, C, D, F or G sold in your state | From 60 days before to 63 days after that coverage ends |
| Your Medigap insurer goes bankrupt, or your policy ends through no fault of your own | Plan A, B, C, D, F or G sold in your state | No more than 63 days after the policy ends |
| You leave a Medicare Advantage plan or drop a Medigap policy because the company broke the rules or misled you | Plan A, B, C, D, F or G sold in your state | No more than 63 days after coverage ends |
Source: CMS, Choosing a Medigap Policy (March 2026), Section 3. Trial rights can last an extra 12 months in some circumstances; ask your state insurance department. Keep the letters, notices, claim denials and postmarked envelopes that show when coverage ended: insurers can ask for proof.
Switching Medigap policies
Federal law doesn’t give you a general right to switch Medigap policies after your Open Enrollment Period unless one of the situations above applies. If an insurer will sell you a new policy anyway, you have a 30-day “free look” to decide whether to keep it; don’t cancel the old policy until you’re sure, and expect to pay both premiums for that month. If you’ve had your current policy at least 6 months and the new one has the same benefits, the new insurer can’t impose a pre-existing condition wait.
States with extra switching rights
These states give people who already have Medigap a recurring chance to change policies without medical underwriting, or an open enrollment right beyond the federal one. Rules differ on who qualifies and which plans you can switch to; follow the source link for the exact terms.
| State | State right |
|---|---|
| California | If you already have Medigap, you get at least 60 days each year starting on your birthday to switch to a policy with the same or fewer benefits, from any insurer, without health questions. (Cal. Ins. Code §10192.11) |
| Connecticut | Insurers can’t deny or condition a Medigap policy based on age, gender, claims history or medical condition, so you can buy or switch any time of year (a pre-existing condition exclusion of up to 6 months is allowed). (Conn. Gen. Stat. §38a-495c(a)-(c)) |
| Delaware | Starting January 1, 2026: a yearly window from 30 days before your birthday to at least 30 days after, to switch to a policy with the same or fewer benefits from any insurer without health questions. (SB 71 (153rd Gen. Assembly), signed 2025-09-03) |
| Idaho | Once a year, during the 63 days starting on your birthday, you can switch to a plan with the same or fewer benefits, with the same or a different insurer, without health questions. (S.B. 1143 (2021); IDAPA 18.04.10) |
| Illinois | Ages 65 to 75: a 45-day window each year starting on your birthday to switch to a policy with the same or fewer benefits from the same insurer or an affiliate, without health questions or health-based pricing. (215 ILCS 5/363(8)) |
| Indiana | Starting January 1, 2026: ages 65+ can switch to another insurer’s policy of the same plan letter by applying within 60 days of their birthday each year, without health questions. Switching letters isn’t covered. (HEA 1226 (2025), Ind. Code §27-8-13-9.3) |
| Kentucky | Once a year you can move to another insurer’s policy of the same plan by applying within 60 days of your birthday, without health questions. No age limit. (KRS 304.14-525 (2023 Ky. Acts ch. 182, HB 345)) |
| Louisiana | Each year, a 63-day window starting on your birthday to buy any Medigap policy from your current insurer or its affiliates. Not a switch to other companies. (La. R.S. 22:1112(A)(1)) |
| Maine | At any time, if you’ve had Medigap or Medicare Advantage with no gap longer than 90 days, you can switch to a Medigap policy with the same or fewer benefits from any insurer, which can’t turn you down. (24-A M.R.S. §5002-B) |
| Maryland | Each year, from your birthday through the next 30 days, you can switch to a policy with the same or fewer benefits from any insurer, without health questions. (Md. Code, Ins. §15-909) |
| Missouri | Each year, from 30 days before to 30 days after your policy’s anniversary date, you can switch to the same plan letter from any insurer without health questions. (20 CSR 400-3.650(13)) |
| Nevada | Each year, from the first day of your birthday month for at least 60 days, you can switch to a policy with the same or fewer benefits, from your current or a new insurer, without health questions. (AB 250 (2021), NRS ch. 689B) |
| Oklahoma | Insurers must let current Medigap holders with no coverage gap over 90 days switch to a policy with the same or fewer benefits without health questions; insurers comply by offering a 60-day window starting on your birthday each year. (OAC 365:10-5-129(f)) |
| Oregon | Each year, from 30 days before to 30 days after your birthday, you can switch to a policy with the same or fewer benefits from any insurer without health questions. (OAR 836-052-0143) |
| Rhode Island | Every year during Medicare Open Enrollment (October 15–December 7, for January 1 coverage), anyone with Medigap or Medicare Advantage and no gap over 90 days can buy any Medigap policy sold in Rhode Island without health questions. (R.I. Gen. Laws §27-18.2-3(h) (P.L. 2025 ch. 433/434)) |
| Utah | Each year, for 60 days starting on your birthday, you can switch to a comparable or lower plan from your current insurer only, without health questions. (Utah Code §31A-22-620(3)(g) (H.B. 258, 2025)) |
| Virginia | Each year, for at least 60 days starting on your birthday, you can buy a policy with the same benefits as yours from any insurer in Virginia, without health questions. (Va. Code §38.2-3611) |
| Washington | You can switch at any time without health questions: from any of Plans B through N to another of Plans B through N, or from Plan A to Plan A. (RCW 48.66.045) |
| West Virginia | Starting June 2026: if your policy has been in force at least 24 months, a 60-day window each year starting the first of your birthday month to switch to a policy with the same or fewer benefits from your insurer or an affiliate, without health questions. (W. Va. HB 4869 (2026 Reg. Sess.)) |
Other state rights
| State | State right |
|---|---|
| Connecticut | Connecticut does not ban Part B excess charges for most people; according to the state’s CHOICES program, only people in the QMB program are protected. (CT ADS CHOICES fact sheet) |
| Delaware | Starting January 1, 2026: if you leave Medicare Advantage for Original Medicare during the fall Open Enrollment or the January–March Medicare Advantage Open Enrollment, insurers must sell you any Medigap policy they offer in Delaware (they may still price by health and apply a pre-existing condition wait). (SB 71 (153rd Gen. Assembly)) |
| Maryland | Starting July 1, 2026: people losing Maryland Medicaid who enrolled in Part B while on Medicaid can buy any Medigap policy without health questions if they apply within 63 days. (2026 Md. Laws ch. 139) |
| Minnesota | Starting with the fall 2026 enrollment periods: people aged 65 to 70 buying Medigap for the first time can do so without health questions during October 15–December 7 and January 1–March 31, with a permanent late-enrollment surcharge. Not a switching right. (Minn. Stat. §62A.31 subd. 1h, 1r; §62A.3099 subd. 18b; Commerce Admin. Bulletin 2026-3) |
States that require Medigap for people under 65
| State | Rule |
|---|---|
| Arkansas | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| California | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Colorado | Insurers must offer the Medigap plans they sell to people under 65 who have Medicare because of a disability, during the 6 months after Part B starts. Premiums can be higher than at 65. (Colo. DOI Reg. 4-3-1 (3 CCR 702-4)) |
| Connecticut | Insurers that sell Medigap to people 65 and older must also offer plans to people under 65 who have Medicare because of a disability. (Conn. Gen. Stat. §38a-495c(d)) |
| Delaware | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Florida | Insurers must offer Medigap to people under 65 with Medicare because of a disability or ESRD during the 6 months after Part B starts, and for 2 months after losing certain other coverage. (Fla. Stat. §627.6741) |
| Georgia | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Hawaii | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Idaho | People under 65 with Medicare because of a disability or ESRD can buy the same plans, at no more than 150% of the age-65 premium; the premium drops to the standard rate at 65. (Idaho DOI SHIBA page) |
| Illinois | People under 65 with Medicare because of a disability can’t be denied if they apply within 6 months of Part B; insurers must offer every policy type they sell at 65+, at no more than their highest 65+ rate. (215 ILCS 5/363(6)) |
| Kansas | People under 65 with Medicare because of a disability can’t be denied if they apply within 6 months of Part B; insurers must offer every policy type they sell at 65+, at no more than the age-65 rate. (K.S.A. 40-2221) |
| Kentucky | Insurers must make every Medigap policy they sell available to people under 65, with premiums capped at their average rate for people 65+ and no pre-existing condition wait. (KRS 304.14-525 (2023 Ky. Acts ch. 182)) |
| Louisiana | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Maine | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Maryland | Insurers must make Plans A and D available to people under 65 with Medicare because of a disability, during the 6 months after Part B starts; the Plan A premium is capped at the average 65+ rate. (Md. Code, Ins. §15-909(b)(3)) |
| Massachusetts | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Michigan | Some insurers must offer Medigap to people under 65 with Medicare; the state insurance department lists the current options. (Mich. Comp. Laws ch. 500 (Medicare supplement)) |
| Minnesota | Medigap open enrollment applies regardless of age, with a 6-month window for people who have Medicare because of a disability, and another at 65. (Minn. Stat. §62A.31 subd. 1h) |
| Mississippi | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Missouri | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Montana | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Nebraska | Since January 1, 2025, insurers that sell Medigap at 65+ must offer Plan A to people under 65 with Medicare because of a disability, during the 6 months after Part B starts, at no more than 150% of the age-65 premium. (LB 852 (2024), Neb. Rev. Stat. §44-3614 et seq.) |
| Nevada | Since October 1, 2025, insurers must let people under 65 with Medicare because of a disability or ESRD buy any Medigap policy they sell at 65+, with premium limits. (SB 292 (2025)) |
| New Hampshire | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| New Jersey | People under 50 with Medicare because of a disability can buy Plan D (Plan C if eligible before 2020) from a contracting insurer at the age-65 premium, through the state’s under-50 program. (N.J.S.A. 17B:26A-14 to -17; N.J.A.C. 11:4-23A and 23B) |
| New York | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| North Carolina | Insurers must offer Plan A (and Plan D or G if they sell it to people new to Medicare) to people under 65 with Medicare because of a disability, without health questions, if they apply within 6 months of Part B. (N.C. Gen. Stat. §58-54-45) |
| Oklahoma | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Oregon | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Pennsylvania | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Rhode Island | Insurers must offer Plan A to people under 65 with Medicare because of a disability or ESRD, during the 6 months after Part B starts. (R.I. Gen. Laws §27-18.2-3(g)) |
| South Dakota | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Tennessee | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Texas | Insurers that sell Medigap at 65+ must offer it to people under 65 with Medicare because of a disability, ESRD or ALS: Plans A, B and D at the age-65 rate, other plans at no more than 200% of it. (Tex. Ins. Code ch. 1652 (HB 2516, 2025)) |
| Vermont | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
| Virginia | Insurers must offer at least one Medigap policy to residents under 65 who have Medicare because of a disability. (Va. Code §38.2-3610) |
| Wisconsin | CMS lists this state among those requiring insurers to offer at least one Medigap policy to some people with Medicare under 65. Ask the state insurance department which plans and who qualifies. (CMS, Choosing a Medigap Policy (March 2026)) |
State rules checked October 17, 2026 against each state’s statute, regulation or insurance department page. Laws change; confirm with your state insurance department before you rely on a state right. Every state’s official guide: Medigap by state.
Before you switch or drop coverage, confirm your rights with Medicare.gov’s “When can I buy a Medigap policy?” and “Can I change my Medigap policy?” tools, your state insurance department, or your State Health Insurance Assistance Program (free counseling). If you drop a Medigap policy, you may not be able to get it back.
Questions
When is my Medigap Open Enrollment Period?
It lasts 6 months and starts the first month you have Medicare Part B and are 65 or older. It happens once and doesn't repeat.
Can I be turned down for Medigap?
During your Medigap Open Enrollment Period or when you have a guaranteed-issue right, no. At other times, insurers in most states can use medical underwriting to deny you or charge more. Some states give extra rights, such as a yearly birthday-rule switch; check the state table on this page.
If I leave Medicare Advantage, can I get Medigap?
Only in certain cases under federal law: your plan leaves Medicare or your area, you move out of its service area, or you're within the first year of a trial right (you joined Advantage when first eligible at 65, or dropped Medigap to try Advantage for the first time). Otherwise you may face medical underwriting, unless your state gives more rights.
What is the Medigap birthday rule?
A state law that lets people who already have a Medigap policy switch to another policy, usually with the same or fewer benefits, during a window around their birthday each year without medical questions. It's a state right, not a federal one; the table on this page lists states with one and links to the law.
Is there a waiting period for pre-existing conditions?
During Open Enrollment, an insurer can make you wait up to 6 months for coverage of a condition treated or diagnosed in the 6 months before the policy starts, but not if you had 6 months of continuous creditable coverage with no gap over 63 days. With a guaranteed-issue right, there's no waiting period.
Sources
Official sources only, checked October 17, 2026.
- CMS and NAIC, “Choosing a Medigap Policy” (CMS Product No. 02110, March 2026) — medicare.gov.
- Medicare.gov, “Can I change my Medigap policy?” — medicare.gov.
- State statutes, regulations and insurance department pages, linked in each state row above.
Educational information, not medical, legal or financial advice. We are not an insurance agent or broker, and we are not connected with or endorsed by the U.S. government or the federal Medicare program. · Advertiser disclosure