If you live in Illinois and have a Medicare Supplement (also called Medigap) plan, you get a yearly chance to switch to a lower-cost plan without answering health questions. It’s called the birthday rule, and it lasts 45 days, starting on your birthday (215 ILCS 5/363).
Here’s how it works, who qualifies, and how to use it well.
What the Illinois Medigap birthday rule says
Every year, if you qualify, you can buy a new Medigap policy during the 45 days that start on your birthday. During that window, the insurer can’t turn you down, delay your coverage, or charge you more because of your health, past claims, or medical history (Illinois General Assembly).
Outside that window, Illinois insurers can usually ask health questions and decide whether to accept you.
Who qualifies for the birthday rule in Illinois
- Age: You’re at least 65 and no older than 75.
- Current coverage: You already have a Medigap policy.
- Residence: Illinois. Your policy is subject to Illinois rules.
If you’re under 65 or over 75, the birthday rule doesn’t apply (Illinois Department on Aging).
The two limits to know
1. Same company or an affiliate. The new plan must come from your current insurer, or a related company that’s authorized in Illinois. You can’t use the birthday rule to move to an unrelated company. The affiliate option was added by Public Act 103-0747.
2. Equal or lesser benefits. You can move to a plan that covers the same or less, never more (Ill. Admin. Code tit. 50, § 2008.100). For example:
- Plan F to Plan G: usually allowed (G covers less).
- Plan G to Plan N: usually allowed.
- Plan A to Plan G: not allowed (G covers more).
Short on time? Book a free 30-minute Medicare check-up and we’ll check your window and your options for you.
An example
Linda lives in Peoria. She turns 70 on March 10 and has Plan G. Her window runs from March 10 to April 23.
Her insurer also offers Plan N for less each month. Because Plan N covers less than Plan G, she can switch during her window with no health questions. She just has to weigh the lower premium against Plan N’s small copays.
How to use your window
- Mark your birthday on your calendar. Then count 45 days. That’s your deadline.
- Ask your insurer for its other plans and prices. Include any affiliate companies.
- Compare the yearly cost, not just the monthly premium. Add up premiums plus likely copays.
- Apply early in the window. Ask when the new plan would start.
- Don’t cancel your current plan until the new one is approved in writing.
Other times you can switch without health questions
- Your Medigap open window: the 6 months starting the month you’re 65 or older and have Part B (Illinois Department on Aging).
- Guaranteed-issue rights: for example, when employer coverage ends or a Medicare Advantage plan leaves your area.
For more on these, see our guide: Can you switch Medigap plans in 2027?
Common questions
Does the birthday rule let me switch Medicare Advantage plans?
No. It applies only to Medigap. Medicare Advantage changes happen during the fall Annual Enrollment Period (October 15 to December 7) or other enrollment periods.
Can I use it every year?
Yes, every year from age 65 through 75, as long as you have a Medigap policy.
Will my insurer tell me about it?
Illinois requires insurers to give notice of this window when you apply for your Medigap policy (215 ILCS 5/363). Most people forget, so set a reminder.
Can I move to a different insurance company?
Not under the birthday rule, unless it’s an affiliate of your current insurer. Switching to an unrelated company usually means answering health questions.
Is your birthday coming up?
Book a 30-minute Medicare check-up. A licensed agent compares your insurer’s plans, shows you the yearly cost, and tells you plainly whether switching makes sense. No cost and no obligation.
Book My Medicare Check-Up or call (786) 730-9658
Prefer to read first? Download the 2027 Medicare Check-Up Checklist.
Related guides
- Can you switch Medigap plans in 2027?
- Medicare Advantage vs. Medigap: which is right for you?
- How to avoid Medicare late enrollment penalties
Sources
- Illinois General Assembly: 215 ILCS 5/363
- Illinois General Assembly: Public Act 103-0747
- Ill. Admin. Code tit. 50, § 2008.100
- Illinois Department on Aging: Medicare Choices Guide
- NAIC: Birthday rule chart by state
We do not offer every plan available in your area. Currently we represent 4 organizations which offer 57 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Simple Start Insurance is a licensed and certified representative of Medicare Advantage organizations and stand-alone prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. Not affiliated with or endorsed by any government agency. This article is general information. Medigap plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
