Key Takeaways

• After age 65, switching Medicare Supplement (Medigap) plans can come with medical underwriting requirements that may lead to higher costs or denial based on your health history.

• Timing is critical. While some states offer guaranteed rights or special enrollment windows, most do not, and you may lose guaranteed issue protections after your initial enrollment period.

Why Switching Medigap Plans Isn’t As Easy As It Sounds

When you first enroll in Medicare Part B, you’re granted a one-time Medigap Open Enrollment Period. This six-month window allows you to buy any Medigap policy available in your state, with no health screening. But after this period ends, especially once you’re past 65, changing your plan becomes more complicated.

The assumption many people make is that they can switch at any time with the same ease. The reality is, you might not qualify for the plan you want unless you’re in perfect health—or live in a state that offers additional protections.

The Importance of Your Medigap Open Enrollment Period

This initial six-month period starts the month you’re both 65 or older and enrolled in Medicare Part B. During this time:

• You cannot be denied coverage for any health condition.

• You can choose any plan sold in your state.

• Premiums are generally more affordable regardless of your medical history.

Once this window closes, insurers can require medical underwriting. This means they can review your health status, medications, and history to decide whether to accept your application or how much to charge you.

What Medical Underwriting Means for You

If you apply for a new Medigap plan after your open enrollment period, you could face:

• Higher premiums based on preexisting conditions.

• Denial of coverage for chronic illnesses like diabetes, heart disease, or recent hospitalizations.

• Coverage exclusions for certain treatments.

In most states, insurers are allowed to use underwriting, so unless you qualify for a specific exception or state rule, you may not be able to switch easily.

Guaranteed Issue Rights: When You Can Switch Without Underwriting

Certain situations give you what are called “guaranteed issue rights.” These allow you to change plans without underwriting, even after age 65. Examples include:

• You lose other health coverage (like a Medicare Advantage plan or employer group health plan).

• Your Medigap insurer goes bankrupt.

• You move out of your plan’s service area.

• You try a Medicare Advantage plan and return to Original Medicare within 12 months (this is the trial right).

These rights are time-limited—usually 63 days from when your previous coverage ends. Missing the window can cost you the opportunity to switch.

State-Specific Rules That Offer Additional Protection

A few states give you more flexibility beyond federal rules. For example:

• New York and Connecticut: Insurers must accept Medigap applications year-round without underwriting.

• Maine: Offers an annual window where you can switch to a plan with equal or lesser benefits.

• California and Oregon: Allow you to switch annually around your birthday without underwriting.

If you live in one of these states, your options are broader, but you still need to act during the right window.

Why People Want to Switch Plans After 65

There are several common reasons you might consider changing your Medigap plan:

• Your current premium has increased significantly over time.

• You want to reduce your out-of-pocket expenses by moving to a more comprehensive plan.

• You initially chose a plan with limited benefits but your needs have changed.

• You realize another plan offers the same coverage for a lower cost—if you’re healthy enough to qualify.

All of these are valid reasons, but you must weigh them against the risks of being denied or charged more based on your current health status.

How Often Can You Switch?

Medicare allows you to apply for a new Medigap policy at any time of year. But again, applying doesn’t guarantee approval. Insurers can:

• Decline your application.

• Offer coverage with a waiting period for preexisting conditions.

• Raise premiums based on health.

So technically you can apply year-round, but practically, timing and health status are everything.

The Birthday and Anniversary Rules in Certain States

States like California and Oregon allow switching Medigap policies around your birthday. Here’s how that works:

• You have a 30-day window (often referred to as a “birthday rule”) to switch to a plan with equal or lesser benefits.

• No underwriting is allowed during this period.

Missouri also has an “anniversary rule” giving you 60 days around your plan anniversary to change insurers—if you keep the same plan type.

If you live in these states, use these annual windows strategically to explore better options without risking denial.

What to Expect If You’re Switching After 70 or 75

The older you get, the more cautious insurers may be. By age 70 or 75:

• You’re more likely to have health conditions that trigger higher premiums or denial.

• Insurers may request more detailed health records.

• Some conditions, like recent cancer or heart failure, could block you from qualifying entirely.

That doesn’t mean switching is impossible, but the barriers increase over time.

Tips to Make Switching Work in Your Favor

If you’re considering switching Medigap plans after age 65, keep these tips in mind:

• Start early: Research your options well before you want to switch.

• Request underwriting forms in advance: See what health questions you’ll need to answer.

• Work with a licensed agent: They can identify which insurers are more flexible with underwriting.

• Time it wisely: Take advantage of state-specific windows like the birthday rule if available.

Even one year can make a difference in your health profile—and your options.

Don’t Confuse Medigap with Medicare Advantage

A common mistake is mixing up Medigap and Medicare Advantage. These are entirely different types of coverage:

• Medigap supplements Original Medicare and allows you to see any doctor that accepts Medicare nationwide.

• Medicare Advantage replaces Original Medicare and typically limits you to a provider network.

Switching from Medigap to Medicare Advantage (or vice versa) involves different timelines, rights, and risks. Know the difference before making any changes.

How to Check If You’re Eligible to Switch Without Risk

Before applying for a new plan, ask these key questions:

• Do I currently have a guaranteed issue right?

• Does my state have special switching windows?

• Am I within a 12-month trial period for a recent Medicare Advantage switch?

• What’s my current health status, and would it affect underwriting?

Being informed ahead of time helps you avoid surprise denials and make more strategic decisions.

What This Means for You in 2025

As of 2025, Medigap plans are still standardized across the U.S., but switching policies after 65 continues to come with limitations unless you qualify for a guaranteed right or live in a more flexible state.

Your decision to switch should never be rushed. Unlike your initial enrollment, switching later requires you to be cautious, informed, and aware of both state laws and your health profile.

Switching Smart Means Asking the Right Questions

If you’re considering a change, now is the time to evaluate your health, your coverage needs, and any state protections that might apply. A licensed agent listed on this website can help you understand the best strategy to switch—or stay put—based on your unique situation.