Indiana Enacts New Medigap 'Birthday Rule' Guaranteeing Annual Plan Changes

Indiana is set to implement a new Medigap policy law, known as the "birthday rule" (HEA 1226), effective January 1, 2026. This law introduces a guaranteed acceptance period for individuals aged 65 or older who are enrolled in a Medicare Supplement (Medigap) plan. Under this law, these individuals will have a 60-day window each year, starting from their birthday, to switch Medigap plans from one insurance company to another without being denied coverage due to preexisting conditions. This change addresses a common concern among seniors who find their Medigap premiums increasing and want to shop for better pricing without risking rejection based on health status. The guaranteed acceptance applies only to those switching to the same lettered Medigap plan they currently hold; for example, a Plan G enrollee can only switch to a Plan G with a different insurer. This rule excludes individuals under age 65 on Medigap plans and those currently enrolled in Medicare Advantage plans, who are not granted the same guaranteed rights to join a Medigap. Insurers may still set premiums based on factors such as age, gender, location, and tobacco use. Consumers seeking to take advantage of this new opportunity can contact insurance providers directly or work with licensed insurance agents or brokers to identify and enroll in alternative plans. The Indiana Department of Insurance will also serve as a resource for complaints related to enrollment denials. Additionally, the State Health Insurance Assistance Program (SHIP) offers support and information about Medicare and Medigap plans.