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Medigap (Medicare Supplement insurance) helps pay what Original Medicare doesn't. The catch: after your first 6 months, an insurer can usually ask about your health before selling you a policy, so switching later can be hard. Some states give you more chances. Below is each state's rule, from the state regulators' own chart (NAIC, May 2026) and state sources: 15 states have a birthday rule, 5 let you switch any time, and a few have yearly or anniversary windows. Plus what each plan letter covers in 2026. We don't sell insurance or give quotes.
Checked Oct. 24, 2026
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“Switch rule” = an extra state right to change Medigap policies without health questions. “Under 65” = NAIC's under-65 column. “CMS list” = on CMS's March 2026 list of states that require at least one Medigap option under 65. Pick your state in the lookup for the full rule.
| State | Switch rule | Under 65 on Medicare | CMS list |
|---|---|---|---|
| Alabama | No state switching window | No state requirement | No |
| Alaska | No state switching window | No state requirement (NAIC: some insurers sell to under-65 anyway, and the state high-risk pool, ACHIA, offers a Medicare carve-out plan) | No |
| Arizona | No state switching window | No state requirement | No |
| Arkansas | No state switching window | Yes, for people with disabilities | Yes |
| California | Birthday rule (since Jan. 1, 2020) | Yes (not for people who qualify only because of ESRD) | Yes |
| Colorado | No state switching window | Yes | Yes |
| Connecticut | Switch any time | Yes, for people under 65 with disabilities | Yes |
| Delaware | Birthday rule (since Jan. 1, 2026) | Yes | Yes |
| District of Columbia | No state switching window | No requirement | No |
| Florida | No state switching window | Yes (since Oct. 1, 2009) | Yes |
| Georgia | No state switching window | Yes | Yes |
| Hawaii | No state switching window | Yes | Yes |
| Idaho | Birthday rule (since March 1, 2022) | Yes (since March 29, 2017) | Yes |
| Illinois | Birthday rule (since Jan. 1, 2022) | Yes | Yes |
| Indiana | Birthday rule (since Jan. 1, 2026) | Yes (NAIC; not on the March 2026 CMS list) | No |
| Iowa | No state switching window | Yes, limited options | No |
| Kansas | No state switching window | Yes (since April 29, 1999) | Yes |
| Kentucky | Birthday rule (since Jan. 1, 2024) | Yes | Yes |
| Louisiana | Birthday rule | Yes | Yes |
| Maine | Switch any time | Yes | Yes |
| Maryland | Birthday rule (since July 1, 2023) | Yes | Yes |
| Massachusetts | Switch any time | Yes (not for people who qualify only because of ESRD) | Yes |
| Michigan | No state switching window | Yes (since 1992) | Yes |
| Minnesota | Yearly window (limited) (since Aug. 1, 2026) | Yes | Yes |
| Mississippi | No state switching window | Yes, for people under 65 with disabilities (6-month window) | Yes |
| Missouri | Anniversary rule (since June 1999) | Yes, for people with disabilities (since June 1999) | Yes |
| Montana | No state switching window | Yes | Yes |
| Nebraska | No state switching window | Yes (NAIC; not on the March 2026 CMS list) | No |
| Nevada | Birthday rule (since Jan. 1, 2022) | Yes (since Oct. 1, 2025) | No |
| New Hampshire | No state switching window | Yes | Yes |
| New Jersey | No state switching window | Yes: every Medigap company must offer at least Plan D to people under 65 with disabilities, at a rate no higher than its age-65 rate | Yes |
| New Mexico | Birthday rule (since Jan. 1, 2027) | No requirement | No |
| New York | Switch any time (since 1996) | Yes (since 1996) | Yes |
| North Carolina | No state switching window | Yes (since Nov. 1, 1998) | Yes |
| North Dakota | No state switching window | No requirement | No |
| Ohio | No state switching window | NAIC: no companies currently selling to people under 65 | No |
| Oklahoma | Birthday rule | Yes | Yes |
| Oregon | Birthday rule (since Jan. 1, 2013 (amended Jan. 1, 2023)) | Yes | Yes |
| Pennsylvania | No state switching window | Yes (since 1994; open enrollment rights also for people eligible because of disability or ESRD) | Yes |
| Rhode Island | Yearly window (limited) (since 2025) | Yes (NAIC; not on the March 2026 CMS list) | No |
| South Carolina | No state switching window | Yes (NAIC; not on the March 2026 CMS list) | No |
| South Dakota | No state switching window | Yes | Yes |
| Tennessee | No state switching window | Yes | Yes |
| Texas | No state switching window | Yes (extra protections for ALS and ESRD added June 1, 2025) | Yes |
| Utah | Yearly window (limited) (since 2025) | No requirement | No |
| Vermont | No state switching window | Yes (since Jan. 1, 1998) | Yes |
| Virginia | Birthday rule (since July 1, 2025) | Yes (since July 1, 2020) | No |
| Washington | Switch any time | No requirement | No |
| West Virginia | Birthday rule (since June 11, 2026) | No requirement | No |
| Wisconsin | No state switching window | Yes | Yes |
| Wyoming | Birthday rule | No requirement | No |
Sources: NAIC chart (May 11, 2026) CMS Choosing a Medigap Policy (2026); Minnesota, Missouri, Connecticut, Washington and Virginia also from the state sources listed below.
| If this happens | You can buy | Apply |
|---|---|---|
| Your Medicare Advantage plan leaves Medicare, stops serving your area, or its network changes significantly, or you move out of its area, and you go back to Original Medicare | Plan A, B, C*, D*, F* or G* | From 60 days before coverage ends to 63 days after |
| Your employer, retiree, COBRA or union plan that pays after Medicare is ending | Plan A, B, C*, D*, F* or G* | Up to 63 days after the latest of: coverage end, the notice date, or a claim denial |
| You move out of your Medicare SELECT policy's area | Plan A, B, C*, D*, F* or G* in your state or the new state | 60 days before to 63 days after the policy ends |
| Trial right: you joined Medicare Advantage or PACE when first eligible and leave within the first year | Any Medigap policy sold in your state* | 60 days before to 63 days after coverage ends |
| Trial right: you dropped Medigap to try Medicare Advantage (or SELECT) for the first time and leave within a year | Your old policy if still sold, otherwise Plan A, B, C*, D*, F* or G* | 60 days before to 63 days after coverage ends |
| Your Medigap company goes bankrupt or your policy ends through no fault of yours | Plan A, B, C*, D*, F* or G* | Up to 63 days after the policy ends |
| You leave Medicare Advantage or drop Medigap because the company broke the rules or misled you | Plan A, B, C*, D*, F* or G* | Up to 63 days after coverage ends |
*C and F only if you were eligible for Medicare before Jan. 1, 2020. Source: Medicare.gov guaranteed issue rights. Your state may add more rights.
Plans with the same letter cover the same things at every company; price is the only difference. Massachusetts, Minnesota and Wisconsin use their own plan designs instead of letters.
| Benefit | A | B | C | D | F | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes |
| Part B coinsurance or copayment | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | 50% | 75% | ✓ Yes | ✓ Yes* |
| Blood (first 3 pints) | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | 50% | 75% | ✓ Yes | ✓ Yes |
| Part A hospice care coinsurance or copayment | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | 50% | 75% | ✓ Yes | ✓ Yes |
| Skilled nursing facility care coinsurance | — | — | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | 50% | 75% | ✓ Yes | ✓ Yes |
| Part A deductible | — | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes | 50% | 75% | 50% | ✓ Yes |
| Part B deductible ($283 in 2026) | — | — | ✓ Yes | — | ✓ Yes | — | — | — | — | — |
| Part B excess charge | — | — | — | — | ✓ Yes | ✓ Yes | — | — | — | — |
| Foreign travel emergency (up to plan limits) | — | — | 80% | 80% | 80% | 80% | — | — | 80% | 80% |
| Out-of-pocket limit (2026) | n/a | n/a | n/a | n/a | n/a | n/a | $8,000 | $4,000 | n/a | n/a |
Source: Medicare.gov plan chart CMS guide
We don't give quotes. The same plan letter can cost very different amounts depending on the company, your age, ZIP code and tobacco use, and how the policy is priced:
All three can still go up for inflation and other reasons. See the policies and price ranges sold in your ZIP code with Medicare.gov Find a Medigap policy, or ask your state insurance department for its rate guide.
Facts, not advice. We don't sell Medigap, recommend plans or companies, or share your answers. No partner links on this page.
It's a state law that gives people who already have a Medigap policy a yearly window around their birthday to switch policies without answering health questions. As of Oct. 24, 2026, 15 states have one on the books (New Mexico's starts Jan. 1, 2027). The rules differ: some let you change companies, some only within your current insurer, and most only to the same or fewer benefits.
Only in certain cases: during your one-time 6-month Medigap Open Enrollment Period, in a federal guaranteed-issue situation (for example your Medicare Advantage plan leaves your area, or your employer retiree plan ends), or if your state gives you a birthday, anniversary, yearly or year-round right. Otherwise the insurer can ask health questions and may say no.
It's the 6 months starting the first month you have Medicare Part B and are 65 or older. It happens once and doesn't repeat each year. During it, a company can't refuse to sell you any Medigap policy it offers or charge more because of your health.
Connecticut and New York sell Medigap year-round without health screening, and all Massachusetts carriers have chosen year-round enrollment. Maine lets you switch to equal or fewer benefits any time if your coverage has been continuous, and Washington lets you switch among Plans B through N (or A to A) any time.
Federal law doesn't require insurers to sell Medigap to people under 65. CMS's March 2026 guide lists 33 states that require at least one Medigap option for people under 65 on Medicare; NAIC's May 2026 chart shows a few more. When you turn 65 you get your own 6-month Medigap Open Enrollment Period anyway.
Everything on the standard chart except the Medicare Part B deductible ($283 in 2026). It covers the Part A deductible, Part B coinsurance and excess charges, skilled nursing coinsurance and 80% of foreign travel emergencies. A high-deductible Plan G in some states starts paying after $2,950 in 2026.
It depends on the insurer, your age, ZIP code, tobacco use and how the policy is priced (community-rated, issue-age or attained-age). We don't give quotes. Medicare.gov's Medigap finder shows the policies and price ranges sold in your ZIP code, and your state insurance department or SHIP can help for free.
Facts, not insurance advice. We don't sell insurance or provide quotes; confirm coverage and requirements with the insurer, an agent or your state insurance department.