How Oregon's birthday rule works
- Check that you qualify. You must have a Medigap (Medicare supplement) policy now. Policies issued before January 1, 1990 don't qualify.
- Find your window. It opens 30 days before your birthday and closes 30 days after it, every year.
- Choose a policy with the same or lesser benefits. The Oregon Division of Financial Regulation publishes the chart that decides "same or lesser" for 1990, 2010 and 2020 standardized plans. The same plan letter always qualifies.
- Apply during the window. The new company may be the same as your current one or different. It can't deny you, add conditions, or price the policy based on your health status, claims experience, receipt of care or medical condition.
- Avoid a gap. Don't cancel your current policy until the new one is approved, and set the cancellation to match the new policy's start date. You have 30 days after a new policy is delivered to return it for a premium refund.
What changed in 2023
Oregon first adopted a birthday rule effective January 1, 2013, with a window that began on your birthday and ran 30 days. The Division of Financial Regulation amended the rule (filed December 22, 2022, effective January 1, 2023) so the window now starts 30 days before the birthday and runs 30 days after it. Older descriptions of a 30-day window starting on the birthday, or claims that Oregon has no birthday rule, are out of date. A 2025 bill to add a yearly Medigap open enrollment for everyone (SB 1181) did not become law.
Timing tips
- Medigap prices for the same plan letter differ between companies; the birthday rule is a yearly chance to compare without health questions.
- Oregon allows companies to price by attained age, and some use other methods; ask how a policy is priced and how its rates have changed.
- The birthday rule doesn't help you move from Medicare Advantage to Medigap. For that, see guaranteed-issue rights, such as when a Medicare Advantage plan ends: for 2027, plans ending in some Oregon counties give members 63 days of guaranteed issue (plans ending in 2027).
More on Medigap in Oregon.
Sources
- Oregon Administrative Rules 836-052-0143 — Annual opportunity to select another Medicare supplement policy or certificate
- Oregon Secretary of State — OAR 836-052-0143, Medicare supplement birthday rule
- Oregon Division of Financial Regulation — Oregon Medicare Supplement Insurance Overview, 2025 legislative presentation (PDF)
- Oregon Administrative Rules 836-052-0160 — Required disclosure provisions (30-day free look)
- Oregon Legislature — SB 1181 (2025)
Frequently asked questions
When is my Oregon birthday rule window?
From 30 days before your birthday through 30 days after it, every year. Since January 1, 2023 the window starts before your birthday; under the earlier rule it started on the birthday itself.
Can a Medigap company turn me down during the window?
No. During the window a company can't deny the new policy, put conditions on it, or set its price based on your health, claims or medical history. It can still charge its regular rate for your age and area.
Which plans can I switch to?
A policy with the same or lesser benefits than the one you have, as defined by the Oregon Division of Financial Regulation's chart. Switching to the same plan letter from another company always qualifies. Plans C and F are sold only to people first eligible for Medicare before 2020.
Who can't use the birthday rule?
People who don't have a Medigap policy now (for example, people in Medicare Advantage) and people whose policy was issued before January 1, 1990. To move from Medicare Advantage to Medigap, look at guaranteed-issue rights instead.
Medicare in your Oregon county
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