What are Medigap Guarantee Issue rights?

Guarantee Issue (GI) rights give you the right to buy a Medigap policy without medical underwriting — meaning insurers cannot deny you coverage or charge higher premiums due to health conditions. Federal GI rights apply during your 6-month Initial Enrollment Period after Part B starts. Some states have additional protections including Birthday Rules and annual open enrollment.

What is the Medigap Birthday Rule?

The Birthday Rule is a state-level protection (in California, Oregon, Missouri, and others) that gives you an annual window around your birthday — typically 30 days — to switch to a Medigap plan with equal or lesser benefits without medical underwriting. This means you can shop for better rates every year, regardless of your health status.

What is the Medigap Trial Right?

If you drop a Medigap plan to try a Medicare Advantage (MA) plan for the first time, you have a 12-month Trial Right to return to your original Medigap plan (or Plan A, B, C, F, K, or L) with GI rights. This window only applies if it was your first time joining MA — it does not repeat if you have switched before.

When does the Initial Enrollment Period for Medigap end?

Your Medigap Initial Enrollment Period (IEP) is a 6-month window that begins the month you are first enrolled in Medicare Part B at age 65 or older. During this window, insurers must sell you any Medigap plan they offer without medical underwriting. After this window closes, you may be denied or charged higher premiums based on health conditions (except in states with additional protections).

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Medigap Versus™ — Component 3

Medigap Guarantee Issue Rights Tracker

Know your enrollment windows. Never miss a Medigap deadline. Find out if your state has a Birthday Rule or annual open enrollment.

States with
enhanced GI rights

6 mo

Federal IEP
window

12 mo

Trial Right
window

Initial Enrollment Period (IEP) Calculator

Your IEP is the most important Medigap window. It opens when you first enroll in Part B at age 65 and lasts exactly 6 months. After it closes, insurers can deny you or charge more based on your health — unless your state has added protections.

Part B Effective Date

Find this on your red, white & blue Medicare card or at mymedicare.gov

Your State

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How to find your Part B effective date Your Medicare card shows your Part A and Part B coverage start dates. You can also check at mymedicare.gov or call 1-800-MEDICARE (1-800-633-4227).

⚠️ Critical: After your IEP closes, you may be denied Medigap coverage or charged significantly higher premiums based on pre-existing conditions — in most states. Apply before your window closes.

Medicare Advantage Trial Right

If you dropped Medigap to try Medicare Advantage for the first time, you have a 12-month Trial Right to return to Medigap with guaranteed issue protection.

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One-time right only The Trial Right applies only the first time you join a Medicare Advantage plan. It does not repeat if you have exercised this right before or if you've had MA coverage previously.

Did you have Medigap before joining your current MA plan?

⚠️ Important: The Trial Right window is strict. If you miss the 12-month deadline, you lose the right to return to Medigap with GI protections (unless your state has additional rules). Plan well in advance.

State-Specific Guarantee Issue Rights

Beyond the federal 6-month IEP, many states have enacted additional protections. Select your state to see all applicable GI windows.

Select Your State

Icons: 🎂 Birthday Rule · 📅 Annual OE · ✅ Year-round · ⭐ Exceptional

States with Enhanced GI Protections

🎂 Birthday Rule State

CaliforniaIdahoIllinoisLouisianaMissouriNevadaOklahomaOregon

📅 Annual Open Enrollment

ConnecticutMaineWashington

✅ Year-Round Open Enrollment

New York

⭐ Exceptional State Protections

MassachusettsMinnesotaWisconsin

⚠️ Data currency notice: State Medigap laws change. Several states have passed new Birthday Rule legislation in 2022–2023. Verify current rules with your state insurance department or a licensed SHIP counselor at shiphelp.org.

MA Plan Termination GI Rights

If your Medicare Advantage plan exits your service area or terminates, you gain automatic Guarantee Issue rights to purchase Medigap — without medical underwriting.

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When MA plan GI rights apply

Your MA plan is discontinuing in your county
Your MA plan withdraws from your state
You involuntarily lose MA coverage (plan terminates you)
You move out of your plan's service area

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When MA plan GI rights do NOT apply

You voluntarily disenroll from MA
Your plan changes benefits but stays active
You switch between MA plans voluntarily

⏱️ Calculate Your Window

Plan Termination / Loss Date

Your State

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How to find out if your plan is terminating CMS requires insurers to notify you by October 1 if your plan will exit your county for the following year. You can also check at medicare.gov/plan-compare or call 1-800-MEDICARE. If you get a termination notice, act immediately — do not wait.

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Your window after plan termination You have 63 days from the date your MA plan coverage ends to enroll in Medigap with GI rights. Start shopping the moment you receive a termination notice — do not wait. You can apply before the termination date and coverage will start after.

Important: MA plan termination GI rights allow you to buy Plans A, B, C (if eligible), F (if eligible), K, or L. Not all Medigap plans are available in all areas. A SHIP counselor can help you understand your specific options for free.

← Take the Medigap Versus™ Assessment Free SHIP Counselor →

Important Disclaimer: This tool provides general educational information only and is not personalized legal, financial, or insurance advice. Guarantee Issue rules are complex and vary by state. Always verify your specific rights with a licensed insurance counselor, SHIP counselor (free), or your state insurance department. Contact your State Health Insurance Assistance Program (SHIP) for free, unbiased assistance: shiphelp.org or call 1-800-MEDICARE.