It’s My Party and I’ll Change if I Want To: Everything You Need to Know About the New “Birthday Rule”

In 1963, Leslie Gore’s song, “It’s My Party,” rose to #1 within 4 weeks. The catchy chorus goes like this:

It’s my party, and I’ll cry if I want to
Cry if I want to, cry if I want to
You would cry too if it happened to you

This past August 2025, a brand-new law passed the Indiana state legislature called the “Birthday Rule.” This law opens up new options for anyone with a Medigap plan beginning in 2026 and every year thereafter!

Now, on your birthday, you can tweak the words to sing:

It’s my birthday, and I’ll change if I want to
Change if I want to, change if I want to
You would change too if it happened to you

Anyone with a Medigap knows that the premium goes up at least annually. It’s an unfortunate and costly birthday gift. Some companies raise their rates a lot quicker than others.

Stable increases run around 5-8% per year, but we’ve talked with clients whose premiums have jumped as much as $100/mo! So, yeah, “You would change too if it happened to you!”

WHY IS “The Birthday Rule” A GAMECHANGER?

Until now, anyone with a Medigap plan knows that generally speaking, it is not possible to change one’s supplement unless one goes through underwriting. 

“The Birthday Rule” effectively nullifies this requirement and allows an applicant to receive a guaranteed issue beginning on the day of their birthday up to 60 days afterward. 

A little background on Medicare options will help underscore how this is going to be helpful. 

A REVIEW OF MEDICARE OPTIONS

Original Medicare (Part A and Part B) does not cover 100% of a beneficiary’s medical expenses. In fact, on its own, it presents significant financial risk for two main reasons.

• There is no max-out-of-pocket limit for Part B medical expenses (members owe 20%).
• In-patient hospital care requires a $1,736 Part A deductible.

To protect themselves from this risk, Medicare beneficiaries have two main options:

• a Part C Advantage plan (private insurance administers Part A and B benefits)
• a Medigap policy (private insurance pays the “gaps” of original Medicare)

While it is possible to make coverage changes every Annual Enrollment Period (AEP), not all enrollment changes are possible because it depends on what you have for coverage. 

It may be a surprise that Medigap holders are not able to change their Medigap plans. 

The following chart illustrates the possibilities.

Because Part C plans do not ever require underwriting, it is easy to change plans and companies during a valid election period. But because Medigap plans require underwriting unless you have a guaranteed issue circumstance, once you choose your Medigap company, you effectively cannot change unless you are “healthy” and can pass underwriting. 

IT’S YOUR BIRTHDAY, YOU CAN CHANGE IF YOU WANT TO

With the passing of “The Birthday Rule”, the underwriting requirements are now waived. So, if your current supplement premium is higher than you like, you can call or text us at 574–544–2228, and we’ll be glad to see what we can do. 

We’ve already helped several people improve their situation. One person we recently quoted was paying well over $300/mo for Plan G, and we were able to find another Plan G for half the amount at just over $150/mo. 

Question: My current company pays so well and I like them, shouldn’t I just keep my current coverage?

Answer: Absolutely not. The laws regulating supplements require that a Plan F, G or N with one company must offer the exact same benefits offered by any other company offering Plan F, G, or N. That means, the new company you switch to will pay just as well and cost you less.

Some supplement companies bundle and integrate additional benefits when you enroll. For example, both Humana and UHC offer supplements that include a fitness benefit, which pays for your gym membership. So, if you switch to a company that does not include that extra benefit, you will have to pay out of pocket for the gym membership. On the other hand, if you are saving $150/mo, you can easily afford to pay that gym membership!

Similarly, sometimes agents will bundle additional products when a client purchases a supplement, such as dental, vision, indemnity, or critical illness plans, etc. Since these are separate policies from the supplement, you can keep those additional products while still changing your supplement plan (they are bundled, not integrated).

Question: How many times can I use the “The Birthday Rule” to change? 

Answer: Until Indiana state law changes again, beneficiaries can use “”The Birthday Rule” every year to find the lowest cost premium possible.

Question: I have Plan F, can I change too?

Answer: Yes! As long as a company offers Plan F (and there are companies that still do), you can use “The Birthday Rule.” Plan F is no longer available to Medicare beneficiaries, so there are no longer younger, healthier people paying into the pot. As a result, Plan F costs are going up exponentially. 

Question: I currently have a Part C Advantage Plan, does “The Birthday Rule” allow me to change to a supplement?

Answer: Unfortunately, no. “The Birthday Rule” only allows Medigap policy holders to change to another Medigap policy of the same letter type. 

Question: I know someone in another state who is paying a lot for their supplement, can they use “The Birthday Rule” to change companies?

Answer: It depends. Most states do not have a “The Birthday Rule” or similar. 

The list of states that currently do include: California, Delaware (added 2025), Idaho, Illinois, Indiana (effective 2026), Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, and Wyoming. 

Question: Does “The Birthday Rule” have any drawbacks?

Answer: Unfortunately, yes. Legislation like “The Birthday Rule” is frequently struck down in states considering them because of the negative impact they have on the overall market. 

The legislator that introduced and promoted the bill in Indiana said that it would reduce cost and offer more choice to Medicare beneficiaries, but the complete opposite happened. 

• Not long after the bill was passed, several companies immediately shut their supplement doors in Indiana resulting in less choice. 
• And across the board, supplement rates have risen. Over two thirds of supplement companies raised their rates by 10% or higher. 

This tracks with what happened in the other states listed above that had previously introduced “The Birthday Rule.” 

For the beneficiary whose premiums have climbed faster and higher than other available companies, that person can benefit from lower cost by using “The Birthday Rule.” But for the rest of beneficiaries whose rates are reasonable, “The Birthday Rule” is causing rates to rise for everyone. 

Question: Why do insurance companies dislike “The Birthday Rule” inclusion? 

Answer: Like all businesses, insurance companies must make a profit to remain in business. Because “The Birthday Rule” offers the ability to change with guaranteed issue, it cannot assess the health/financial risk of the applicant or factor that into the premium charged. 

As a result, actuaries by default consider anyone using “The Birthday Rule” as “bad (unhealthy) business.” Unhealthy business means high expenses that are ultimately shared by all the other supplement holders in that company’s plan. 

Additionally, as explained above, most people who take out a supplement never change it until they eventually switch to a Part C Advantage plan. So, the supplement company can count on longer term business. Stable business means better cost projections and comparably cheaper rates. “The Birthday Rule” means everyone is now a flight risk. 

Question: Why should we consult with Guidepost Insurance on “The Birthday Rule” incorporation?

Answer: We are local, compassionate agents who represent you, not an insurance company. We care about our clients and always seek to do what is in their best interest. 

• Not all agents do this. 
• Not all agents offer all options. 
• Not all agents educate their members because of the potential negative impact it may have on their bottom line. 

Most importantly, we don’t cost you a penny, the plans and benefits we offer are identical to what you can find online or by calling 800, and you have a local resource you can lean on when you have questions, concerns, or problems. 

If you already have an agent that you are happy with, we recommend you check with them first. If you don’t already work with someone or are dissatisfied with their service, please give us a call.