What the California birthday rule actually says
California Insurance Code section 10192.11, subdivision (h), entitles every California Medicare Supplement policyholder to an annual open enrollment period lasting 60 days or more, commencing with the individual's birthday. During that window you may purchase any Medicare supplement policy that offers benefits equal to or lesser than those provided by your previous coverage, and no insurer may deny you, condition your coverage, or charge you a different price because of your health status, your claims history, care you have received, or a medical condition. Two conditions decide whether it applies to you. You must already be covered under a Medicare Supplement policy on the day the window opens, and the plan you move to cannot be richer than the one you leave. The version in force today took effect January 1, 2020 under Senate Bill 407.
How to use your 60 days, step by step
Your window opens on your birthday and stays open at least 60 days, so the work is best done in the two weeks before it. Start by writing down three things: your current plan letter, what you pay per month right now, and your policy's effective date. Then compare what other carriers charge for that same letter, or for a lighter one, in your ZIP code. Apply inside the window, and state on the application that you are using the birthday rule so the new carrier processes it as guaranteed issue rather than as an underwritten application. Do not cancel the old policy until the new one is approved and you have the effective date in hand. A short overlap costs one month of premium; a gap can cost you the coverage. We run this comparison for California clients at no cost: (818) 472-5484.
What equal or lesser benefits means, plan letter by plan letter
Equal or lesser is a benefits test, not a price test. You may move from Plan G to Plan N, from Plan F to Plan G, or to the same letter with a different company at a lower rate. You may not move up: Plan N to Plan G is an upgrade and the birthday rule does not cover it. California wrote the old and new plan generations into the statute so nobody has to argue about them. A 1990 Plan A, B, C, D, F, G, K or L counts as equal to the 2010 version of the same letter. A 1990 Plan E or Plan H counts as equal to a 2010 Plan D, a 1990 Plan I counts as equal to a 2010 Plan G, and a 1990 Plan J, including the high deductible version, counts as equal to a 2010 Plan F. Innovative extras a carrier adds on its own, such as gym or vision perks, are excluded from the comparison entirely. One standardized benefit is worth checking before you move to a lighter letter, because among the Medigap plans sold today only C, D, F, G, M and N include foreign travel emergency coverage, which is explained in Medicare coverage for care in Israel.
Your carrier has to warn you, and most people miss the letter
California does not leave the timing to you. Under the same statute, your Medigap insurer must notify you of your birthday rule rights at least 30 days and no more than 60 days before your window opens, and again on any notice announcing a benefit change or a premium adjustment. The letter telling you your rate is going up is legally required to tell you how to leave. Most people read the new premium, sigh, and file it. Nevada requires the same 30 to 60 day advance notice under NRS 687B.352. If you never find your letter you do not lose anything, because the window is set by your birthday and not by the mail. Check your date, count 60 days forward, and act inside it.
Birthday rules in the states we are licensed in
Lara Goulson is licensed in eleven states and three of them have a birthday rule: California, Nevada and Idaho. The windows are not the same length, they do not all start on the same day, and one of them starts on the first of the month rather than on your actual birthday. The table below is drawn from the statutes and from each state's own regulator rather than from summaries. In the other eight states we serve, switching a Medigap policy outside a guaranteed issue event normally means answering health questions, so the timing conversation there is a different one. New York is the exception among our states: it has no birthday rule because it does not need one, since Medigap there is guaranteed issue year round.
| State | Birthday rule window and what it allows |
|---|---|
| California | 60 days or more, starting on your birthday. Switch to equal or lesser benefits with any carrier, no health questions and no price difference for health. California Insurance Code section 10192.11(h). |
| Nevada | At least 60 days, starting the first day of your birth month. Equal or lesser benefits, from your existing carrier or a new one, no underwriting. NRS 687B.352, and the Division of Insurance AB 250 guidance confirms the carrier switch. |
| Idaho | 63 days, starting on your birthday. Similar or lesser coverage, from any company selling policies in Idaho, no health questions. Idaho Department of Insurance, effective after February 28, 2022. |
| Arizona, Arkansas, Colorado, Florida, Hawaii, Michigan, Texas | No birthday rule. Switching outside a guaranteed issue event normally requires medical underwriting, so the first choice carries more weight. |
| New York | No birthday rule and none needed. Medigap is guaranteed issue year round and premiums do not vary by age or health. |
Sources: California Insurance Code section 10192.11, Nevada Revised Statutes 687B.352 with the Nevada Division of Insurance AB 250 guidance, and the Idaho Department of Insurance. Verified September 2026.
Four ways people lose the window
The first mistake is assuming the rule creates coverage. It does not. If you are on a Medicare Advantage plan you have no Medigap policy to switch, so the birthday rule is not yours to use, and your route back to Original Medicare with a Supplement runs on different rules. The second is cancelling first. Approval comes before cancellation, every time. The third is trying to upgrade. Moving to a richer plan letter is medical underwriting, not the birthday rule, and a carrier that quotes a good price on a bigger plan can still decline you. The fourth is waiting. Sixty days sounds generous until a carrier asks for a document, and an application submitted on day 58 can miss. If your birthday falls in the next 90 days, this is the call to make now.
Find your window and use it
Tell us your birthday, your ZIP code, and the plan letter printed on your current Medicare Supplement card. That is enough to tell you when your window opens, what the same letter costs elsewhere in your area, and whether moving is worth it at all. Sometimes it is not, and we will say so. Lara Goulson is an independent agent licensed in California, Nevada and Idaho along with eight other states, and works with clients in English, Spanish and Hebrew. A review costs nothing. Carriers pay agent compensation, so your premium is identical whether you use an agent or apply on your own.
Call or text (818) 472-5484 with your birthday and we will map your 60 day window.
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