Every fall, clients ask whether they can switch Medigap carriers after a rate increase. In Idaho the honest answer is "often, but only inside a window, and only to a plan that is comparable or lesser." This guide quotes the rule as the Idaho Department of Insurance wrote it and turns it into a checklist.
The Short Version: Key Takeaways
- The birthday rule is real and Idaho-specific. For a Medigap policyholder who, on or after March 1, 2022, voluntarily replaces a policy with another Medigap policy, the guaranteed issue period "begins on the individual's birthday and ends sixty-three (63) days thereafter" (IDAPA 18.04.10, section 041.03.g).
- It is Medigap to Medigap. It does not move you between Medicare Advantage and Medigap, and it does not give you a right to a richer plan.
- "Comparable or lesser" is the test. A new policy qualifies unless it "contains one (1) or more significant benefits not included" in the one being replaced (section 041.05.f).
- Other windows exist. Your six-month open enrollment, a lost employer plan, a Medicare Advantage plan that ends and the trial-right periods each have their own rules (sections 036 and 041).
- Standardized plans pay the same benefits. CMS says the difference between insurers is generally the cost (CMS Medigap page), so a switch is a price question.
- Order matters. Get the new policy issued, and only then end the old one.
Not sure whether you are inside a window today?
Tell us your birthday and your current plan letter. We count the days, check what your plan covers and show you what a switch could and could not do.
Call or text 208-350-9933 Send us a messageWhy People Switch Medigap Plans
A Medigap policy helps pay costs Original Medicare leaves, such as deductibles and coinsurance. CMS says insurers can only sell "standardized" policies, and "the standardized Medigap policies that insurance companies offer must provide the same benefits" (CMS Medigap page). That is why two carriers' Plan G policies cover the same things but can charge different premiums.
| Feature | Same across carriers? | What it means for a switch |
|---|---|---|
| Benefits of a given plan letter | Yes, standardized | A Plan G to Plan G move changes the premium and the carrier, not what is paid |
| Premium | No | The main reason to compare; CMS notes costs can vary |
| Renewal | Guaranteed renewable while premiums are paid | Your current policy continues as long as you pay the premium, so there is no pressure to switch in a hurry |
| Spouses | Each person needs a separate policy | You and your spouse can switch independently, in different windows |
Source: CMS, Medigap (Medicare Supplement Health Insurance), page last modified December 20, 2024, accessed November 12, 2026.
Because the benefits match, a switch comes down to premium, rate history and service. If your plan is working and the premium is competitive, staying put is a good decision.
Four Ways to Switch Without Health Questions
Outside a protected window a carrier may be allowed to ask health questions. Idaho's rule creates several windows; the birthday window is the one most people can use every year.
| Window | Who it is for | How long it runs | Rule |
|---|---|---|---|
| Open enrollment | A person aged 65 or older who is enrolled in Medicare Part B, or someone under 65 with Part B because of disability | Six months, starting the first day of the month you are both 65 or older and enrolled in Part B | Section 036 |
| Birthday window | A person who already has a Medigap policy and voluntarily changes to another Medigap policy | Begins on the birthday, ends 63 days later | Sections 041.02.j and 041.03.g |
| Guaranteed issue events | An employer plan that supplemented Medicare ends, a Medicare Advantage plan ends or leaves your area, a Medigap issuer becomes insolvent, and similar events | Generally from the notice or termination date to 63 days after coverage ends | Sections 041.02 and 041.03 |
| Trial rights | A person who tried Medicare Advantage for the first time and leaves within 12 months, in the situations the rule describes | Begins 60 days before a voluntary disenrollment and ends 63 days after it | Sections 041.02.f, .g, .h and 041.03.d |
Source: Idaho Administrative Code, IDAPA 18.04.10, sections 036, 041.02 and 041.03 (text marked 3-31-22), accessed November 12, 2026. Summary in plain English by Personal Touch; the rule text controls.
The Idaho Birthday Rule, Line by Line
Where the rule came from
Senate Bill 1143, signed on April 22, 2021, revised Medicare Supplement eligibility and rating, and the Idaho Department of Insurance wrote the details into IDAPA 18.04.10. Its Bulletin 21-04 states that "after February 28, 2022, Medicare Supplement policyholders may change plans annually on a guaranteed issue basis during a sixty-three day enrollment period beginning on the policyholder's birthday" (Bulletin 21-04).
What the rule text says
| Piece | What the rule says | Plain English |
|---|---|---|
| Who is eligible (041.02.j) | "The individual is enrolled in a Medicare Supplement policy, and, on or after March 1, 2022, voluntarily terminates enrollment and enrolls in another Medicare Supplement policy." | You must already have a Medigap policy, and the change must be your choice |
| When (041.03.g) | "The guaranteed issue period begins on the individual's birthday and ends sixty-three (63) days thereafter." | One window a year, starting on your birthday |
| What plan (041.05.f) | "Any comparable or lesser Medicare policy offered by any issuer." A policy is comparable or lesser "unless it contains one (1) or more significant benefits not included" in the policy being replaced. | Any carrier, but not a richer plan |
| What the carrier cannot do (041.01.b) | Deny or condition the policy, price it differently for health status, claims experience, receipt of health care or medical condition, or exclude benefits for a preexisting condition | No health questions that change the answer |
Source: IDAPA 18.04.10, sections 041.01.b, 041.02.j, 041.03.g and 041.05.f, accessed November 12, 2026. Quotations are from the rule's current text.
What the rule does not say
The rule does not create a right to move up to a richer plan, does not apply to people who hold only Medicare Advantage, and does not lower your current rate. It also does not require a carrier to accept an application after the window closes.
When Your Window Opens and Closes
Counting 63 days forward from sample 2027 birthdays gives these dates. This is our calculation from the rule's wording; confirm your dates with the carrier.
| Birthday | Window opens | Window ends (63 days later) |
|---|---|---|
| January 15 | January 15, 2027 | March 19, 2027 |
| March 1 | March 1, 2027 | May 3, 2027 |
| June 10 | June 10, 2027 | August 12, 2027 |
| September 20 | September 20, 2027 | November 22, 2027 |
| November 30 | November 30, 2027 | February 1, 2028 |
| December 20 | December 20, 2027 | February 21, 2028 |
Source: Personal Touch calculation from IDAPA 18.04.10, section 041.03.g (window begins on the birthday and ends 63 days thereafter), accessed November 12, 2026.
Apply early in the window, not on the last day, and keep the old policy in force until the new one is issued. Put the window on your calendar every year.
What "Comparable or Lesser" Means
The rule defines the test in one sentence: a policy has comparable or lesser benefits "unless it contains one (1) or more significant benefits not included in the Medicare Supplement policy or certificate being replaced" (section 041.05.f). All standardized plans share the core benefits (Part A coinsurance and extra hospital days, the first three pints of blood, Part B coinsurance and hospice cost sharing) and then add different extras.
| Plan | Part A deductible | Skilled nursing coinsurance | Part B deductible | Part B excess charges | Foreign travel emergency | Open to people newly eligible from 2020 | Add-on categories (of 5) |
|---|---|---|---|---|---|---|---|
| Plan A | No | No | No | No | No | Yes | 0 |
| Plan B | 100% | No | No | No | No | Yes | 1 |
| Plan D | 100% | Yes | No | No | Yes | Yes | 3 |
| Plan G | 100% | Yes | No | Yes | Yes | Yes | 4 |
| Plan M | 50% | Yes | No | No | Yes | Yes | 3 |
| Plan N | 100% | Yes | No | No | Yes | Yes | 3 |
| Plan C | 100% | Yes | 100% | No | Yes | No | 4 |
| Plan F | 100% | Yes | 100% | Yes | Yes | No | 5 |
Source: IDAPA 18.04.10, sections 022 and 025, accessed November 12, 2026. Plan N also charges copays of up to $20 per office visit and up to $50 per emergency room visit (section 022.04.k). Plans K and L use a different structure and are not shown.
How many of the five add-on benefit categories each plan includes
Source: Personal Touch count from IDAPA 18.04.10, sections 022 and 025. Categories counted: Part A deductible, skilled nursing coinsurance, Part B deductible, Part B excess charges, foreign travel emergency care. Darker bars are plans closed to people newly eligible for Medicare on or after January 1, 2020. The same counts appear in the last column of the table above.
How the test plays out between two popular plans
Reading the rule text, Plan N is made of the core benefits, the Part A deductible, skilled nursing coinsurance and foreign travel emergency care, plus copays. Plan G contains all of those except the copays and adds Part B excess charges. So a move from Plan G to Plan N changes to a plan with no benefit Plan G lacks, which fits "comparable or lesser." A move from Plan N to Plan G brings in a benefit Plan N does not have, which a carrier may treat as a significant benefit not included, and then the guaranteed issue protection may not apply. This is our reading of the rule's wording, not a ruling. The carrier makes the call, so ask it in writing before you cancel. Our Plan G vs Plan N guide covers the cost trade between the two.
The safest birthday switch is the same plan letter with a different carrier: Plan G to Plan G is comparable by definition. Stepping down has a cost too, because the rule gives you no right to step back up, so a carrier may ask health questions if you want Plan G again later.
Thinking about moving from Plan G to Plan N, or the other way?
The direction matters under the rule. Tell us your plan letter and carrier and we check the move against the rule text and the carrier's own answer before you apply.
Call or text 208-350-9933 Send us a messageGuaranteed Issue Beyond Your Birthday
The birthday rule is one entry in a longer list. Section 041 of the Idaho rule lists the situations in which a person is an "eligible person" with a guaranteed right to a Medigap policy, and section 041.03 sets how long each window lasts.
| Situation | Window | Rule |
|---|---|---|
| An employer plan that supplements Medicare ends or stops providing all supplemental benefits | From the later of the notice or the date coverage ends, to 63 days after | 041.02.a, 041.03.a |
| A Medicare Advantage plan ends, leaves your area, or you move out of its area | Begins when you receive notice of termination, ends 63 days after coverage ends (involuntary) | 041.02.b, 041.03.b |
| Your Medigap issuer becomes insolvent or your coverage ends involuntarily | Begins on the earlier of the notice or the termination, ends 63 days after coverage ends | 041.02.e, 041.03.c |
| You tried Medicare Advantage for the first time after having Medigap, and leave within 12 months | Begins 60 days before a voluntary disenrollment and ends 63 days after it | 041.02.f and .g, 041.03.d |
| Voluntary Medigap-to-Medigap change (the birthday rule) | Begins on your birthday, ends 63 days later | 041.02.j, 041.03.g |
Source: IDAPA 18.04.10, sections 041.02 and 041.03, accessed November 12, 2026. Selected rows, summarized by Personal Touch; the rule lists more situations and conditions.
For the events in section 041.02.a through .e the rule entitles you to a Plan A, B, C, F, K or L from any issuer, or, for people newly eligible on or after January 1, 2020, the redesignated D and G plans (sections 041.05 and 025.03). If you are on Medicare Advantage and want Medigap, these events, not the birthday rule, are the route. Our guide to Medicare Advantage vs Medicare Supplement covers how to choose between the two structures.
What the Rules Say About Price
We do not publish carrier premiums here because no official Idaho premium table is available to us; premiums vary by carrier and are quoted to you. What the rule does tell us is how premiums may be built.
| Rule | What it says | Why it matters when switching |
|---|---|---|
| Age rating on policies issued after February 28, 2022 | Using increasing age or issue age as a basis for premiums is an unfair practice (056.06.b) | A replacement policy is a new policy, so it is priced without an age basis |
| Policies issued before March 1, 2022 | Issue-age rating is allowed under the older rule (056.06.a) | If you hold an older issue-age policy, any age advantage you have does not carry to a new policy |
| Fees and payment terms | No application or policy fees and no premium variation by payment method or frequency for policies issued after February 28, 2022 (056.09.b) | Compare the plain premium, not a payment-method trick |
Source: IDAPA 18.04.10, section 056 and Idaho Department of Insurance Bulletin 21-04, accessed November 12, 2026.
Bulletin 21-04 adds that advertising quoting issue-age rates must say they are valid only for coverage starting before March 1, 2022. If a quote sounds too good for your age, ask how it is built.
A Safe-Switch Checklist
A guaranteed issue right means the carrier cannot refuse you. It does not protect you from a gap in coverage or a missed deadline. Use this order.
| Step | What to do | What the rule says |
|---|---|---|
| 1 | Confirm you are inside a window and find the last day | Birthday window: begins on the birthday, ends 63 days later (041.03.g) |
| 2 | Confirm the new plan is comparable or lesser | Not comparable if it has a significant benefit the old plan lacks (041.05.f) |
| 3 | Apply with the new carrier; keep the old policy in force | Do not end the old policy until the new one is issued and effective (our ordering) |
| 4 | Read the replacement notice you are given before the policy is issued | Issuers and agents must furnish a replacement notice, with a signed copy to you (071.05) |
| 5 | Use the 30-day return right if you change your mind | Policies must state you may return the policy within 30 days of delivery for a premium refund (066) |
| 6 | Confirm no new waiting period on similar benefits | A replacing policy waives preexisting, waiting and elimination periods for similar benefits to the extent time was served (081) |
| 7 | End the old policy once the new one takes effect, and keep the paperwork | Selling an individual more than one Medigap policy is banned (076), so match the end date to the new effective date |
Source: IDAPA 18.04.10, sections 041, 066, 071, 076 and 081, accessed November 12, 2026. Steps 3 and 7 are Personal Touch's practical ordering of the rule requirements.
Section 076 says an agent "makes reasonable efforts to determine the appropriateness of a recommended purchase or replacement." If we cannot show you a clear reason to switch, we tell you to stay.
The 2027 High-Deductible Plan G
Plan G can also be sold with a high deductible. CMS announced that, effective January 1, 2027, the annual deductible for high-deductible Plans F, G and J is $3,050.
| Item | 2027 figure or rule |
|---|---|
| Annual deductible, high-deductible Plans F, G and J | $3,050 |
| How CMS sets it | Starts at $1,500 for 1998 and rises with the CPI-U; the 2025 to 2026 increase is 3.40%, rounded to the nearest $10 |
| Who can buy high-deductible Plan G | People new to Medicare on or after January 1, 2020, and others under the redesignation in Idaho's rule (section 025) |
Source: CMS, Medigap high-deductible options F, G and J for calendar year 2027 (October 2026 announcement) and IDAPA 18.04.10, section 025, accessed November 12, 2026.
Under the birthday rule, a high-deductible plan carries a deductible the old one lacked, so the carrier decides whether it counts as comparable or lesser; do not assume.
What to Watch This Year
- Your renewal notice. A rate increase letter is a reason to count the days to your next window, not to cancel the same week.
- Your birthday. The window opens on it. Put the date, and the day 63 days later, on your calendar now.
- Advantage plan changes. If a Medicare Advantage plan you hold ends for 2027, that is a guaranteed issue event with its own window (section 041.03.b).
- 2027 Part B figures. CMS has not yet published the 2027 Part B premium and deductible; we label them pending.
Want us to count the days and compare the carriers?
We check your window, your plan letter and the current rates from the carriers we represent. If a switch does not make sense, we say so. Our help costs you nothing.
Call or text 208-350-9933 Send us a messageHow We Built This Page
Every rule here comes from the text of IDAPA 18.04.10, the Idaho Department of Insurance's Medicare Supplement rule (version marked 3-31-22, read in full on November 12, 2026), and from the department's Bulletin 21-04. Plan benefits come from sections 022 and 025. The 2027 high-deductible figure comes from the CMS October 2026 announcement. We quote the rule where wording matters and say so where we give our own reading.
Limits: this page lists no premiums, the 63-day end dates are our calculation, and we did not confirm any carrier's internal handling of applications; the carrier's decision on whether a plan is comparable or lesser governs your case. The page is a snapshot dated November 12, 2026, general education and not individual advice. Personal Touch Ins. & Benefits, LLC is an independent agency; call 208-350-9933 and we compare it for you.
Want to know if a Medigap switch makes sense for you?
Send us your current plan letter, your birthday and your carrier. We check whether you are inside a window, compare the carriers we represent on current rates and service, and tell you plainly if staying put is the better move. We meet by Zoom, phone or in Idaho City by appointment.
Call or text 208-350-9933 Send us a messageFrequently Asked Questions
What is the Idaho Medigap birthday rule?
Idaho lets someone who already has a Medigap policy change to another Medigap policy once a year on a guaranteed issue basis. The enrollment period begins on the policyholder's birthday and ends 63 days after it (IDAPA 18.04.10, sections 041.02.j and 041.03.g). The new policy must be comparable or lesser, and the carrier cannot turn you down or charge more for your health. We check your window and plan with you at no cost: call or text 208-350-9933.
Can I move from Plan N to Plan G using the birthday rule?
Probably not through the birthday rule alone. The rule covers a policy with "comparable or lesser" benefits and says a policy is not comparable if it contains one or more significant benefits not included in the policy being replaced (IDAPA 18.04.10, section 041.05.f). Plan G includes Part B excess charges coverage that Plan N does not, so a carrier may treat it as a step up. Ask the carrier before you cancel anything; we check it with you.
When does my birthday window start and end?
It starts on your birthday and ends 63 days later. For a January 15 birthday in 2027 that is March 19, 2027. Treat the last day as a deadline for a complete application, not a day to begin one, because the new carrier needs time to process it. We count the days with you; call or text 208-350-9933.
Does the birthday rule let me move from Medicare Advantage to Medigap?
No. The birthday rule applies to people who already hold a Medigap policy and want a different one. Moving from a Medicare Advantage plan to Medigap follows other rules: a new Medigap policy cannot take effect until your Medicare Advantage coverage ends (IDAPA 18.04.10, section 076), and whether the carrier can ask health questions depends on whether you qualify for a guaranteed issue right under section 041. We check which right applies to you; call or text 208-350-9933.
Will I have a new waiting period if I switch Medigap plans?
Generally not for benefits you already had. Under IDAPA 18.04.10, section 081, a replacing Medigap policy waives preexisting condition, waiting and elimination periods for benefits similar to those in the old policy to the extent that time was already served. Read the outline of coverage, and we go through it with you.
Should I switch just because my premium went up?
Not automatically. Standardized plans pay the same benefits whichever carrier sells them, so price is the main difference, but a lower first-year rate can rise later. We compare carriers' current rates, rate history and service with you, then you decide. Premiums vary by carrier and are quoted to you.
Keep Reading
Sources
- Idaho Administrative Code, IDAPA 18.04.10, Medicare Supplement Insurance Standards (Idaho Department of Insurance rule), accessed November 12, 2026
- Idaho Department of Insurance, Bulletin No. 21-04 (Medicare Supplement eligibility and rating, Senate Bill 1143), accessed November 12, 2026
- CMS, Medigap (Medicare Supplement Health Insurance), accessed November 12, 2026
- CMS, Deductible Amount for Medigap High Deductible Options F, G and J for Calendar Year 2027 (October 2026 announcement), accessed November 12, 2026
Figures are labelled with the year they apply to and were checked against the official sources above on the date shown. This page is general education, not individual advice. Personal Touch Ins. & Benefits, LLC is not connected with or endorsed by the U.S. government or the federal Medicare program.