New “Birthday Rule” May Give You More Options
West Virginia has a new law that gives people enrolled in Medicare Supplement (Medigap) plans an opportunity each year to review their coverage and potentially switch to a different Medigap plan without medical underwriting.
The new law, House Bill 4869, became effective June 11, 2026. Under the new “birthday rule,” eligible Medigap policyholders have a 60-day application window beginning on the first day of the month of their birthday.
What Does This Mean for You?
If you have had your current Medicare Supplement policy continuously for at least 24 months, you may be able to switch to another Medigap policy with the same or lesser benefits without answering health questions or being denied coverage because of your health history.
Generally, the new policy must be offered by your current insurance company or an affiliated company. There is an exception if your current insurer and its affiliates have not offered an eligible comparable plan for at least 12 months.
Who May Qualify?
You may be eligible if:
- You are currently enrolled in a Medicare Supplement (Medigap) plan.
- You have maintained your current Medigap coverage continuously for at least 24 months.
- You are applying during your 60-day birthday application window.
- The new plan provides the same or lesser benefits than your current plan.
The birthday rule does not apply to people enrolled in Medicare Advantage plans, and it does not allow you to switch to a plan with greater benefits under this particular guaranteed-issue opportunity.
Have Questions? We Can Help!
Medicare and insurance decisions can be confusing, and you don’t have to figure it out alone.
David Summers, our Social Service Coordinator, is available to help answer your questions and help you understand your options. His services are FREE of charge to our seniors.
If you are wondering whether this new opportunity could apply to you, contact us to schedule an appointment with David. He can sit down with you, review your current plan, and help you understand what questions to ask before making a change.
📞 Call 304.366.8779 to schedule an appointment.
Don’t make a change simply because you can—make sure the change is right for you. Let us help you understand your options!