Special Exceptions: Waiver States and Birthday Rules

State laws play an essential role in Medigap policy options. Three states—Massachusetts, Minnesota, and Wisconsin—do not use the standardized alphabetical Medigap plan structure (Plans A through N) used across the rest of the country. Instead, these “waiver states” offer their own state-standardized supplemental benefit packages. If you move into or out of Massachusetts, Minnesota, or Wisconsin, your transition requires careful navigation of state-specific plan structures.

Furthermore, several states have enacted consumer-friendly legislation designed to protect Medigap policyholders. States like California, Oregon, Nevada, Idaho, Illinois, and Maryland enforce “birthday rules” or annual switching windows. These state regulations permit current Medigap policyholders to switch to an equal or lesser Medigap plan around their birthday each year without answering health questions or undergoing medical underwriting. Moving to one of these states eventually unlocks helpful consumer protections that make managing health coverage easier over time.