Maryland adopted a Medicare Supplement (Medigap) "birthday rule" that took effect on July 1, 2023, giving policyholders a yearly chance to switch without underwriting. The Maryland birthday rule opens a window that includes your birthday and the 30-day period following it, during which you can move to an equal-or-lesser plan from any insurer, and your carrier must mail you a notice of the right before your birthday arrives. This guide explains how Maryland's birthday rule works, the notice insurers must send, how the standardized A-through-N plans fit together, which plans are closed to newer enrollees, and where to check which plans count as equal or lesser value.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
How Medigap works in Maryland
A Medigap policy is private insurance that pays the deductibles and coinsurance Original Medicare leaves to you. Medigap (Medicare Supplement Insurance) works only alongside Original Medicare, not with a Medicare Advantage plan, and each policy covers one person. A married couple who both want coverage need two policies.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Jul 22, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
Maryland uses the federal standardized framework. Medigap is sold as lettered plans, A-D, F, G, and K-N, and the benefits inside each letter are fixed by federal rule. Plans E, H, I, and J are no longer sold, though anyone who already holds one can generally keep it.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Jul 22, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits A Plan G from one Maryland insurer covers exactly what a Plan G from another covers. Insurers compete on price, service, and rate stability, not on what the plan pays. That makes the plan letter your first decision and the insurer your second.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Jul 22, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
The gaps Medigap closes are real. After the Part B deductible ($283 in 2026), Original Medicare covers the approved amount for most outpatient care minus a 20% coinsurance that falls to you, with no annual cap. Part A adds a hospital deductible of $1,736 per benefit period in 2026, and that deductible can apply more than once in a year. Medigap caps that exposure.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
The Maryland birthday rule
Maryland's annual protection is the birthday rule, which took effect on July 1, 2023. Under Maryland law, a Medigap policyholder with a policy issued in Maryland has an annual open enrollment period that includes their birthday and the 30-day period following it, during which they may change, without underwriting, to a Medigap policy of equal or lesser benefits, and they do not have to stay with their current carrier, according to the Maryland Insurance Administration.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Maryland's window sits on the shorter end among the states that have adopted a birthday rule; California's, by comparison, runs 60 days. That makes the timing especially worth tracking here, because the window closes fast once it opens.Centers for Medicare & Medicaid Services. (n.d.). Get Medigap Basics - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics
The annual notice is a Maryland-specific feature worth watching for. Because insurers must send it 30 to 60 days ahead of your birthday, you should receive a reminder each year before the window opens. Use that lead time to shop, since the window closes 30 days after your birthday unless your carrier chooses to extend it. Maryland's rule applies to policies issued in Maryland.
The "equal or lesser benefits" limit is the key constraint. You can move sideways (Plan G to another Plan G) or down to a less generous letter (Plan G to Plan N), but the birthday rule does not let you move up to a more comprehensive plan. Moving up still requires medical underwriting outside a guaranteed-issue window, so a switch from Plan N to Plan G is not protected by the birthday rule.
How to use the Maryland birthday rule
The window is short, so use the advance notice to prepare.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Watch for the notice
Your insurer must send a notice of the switch right 30 to 60 days before your birthday. When it arrives, that is your cue to start comparing plans.
Confirm the new plan is equal or lesser
Identify your current plan letter, then pick a new policy of the same letter or a less comprehensive one. A Plan G holder can switch to another Plan G or down to Plan N.
Apply before the window closes
The application has to be submitted during the window, which runs through the 30th day after your birthday, but the Maryland Insurance Administration notes there is no legal requirement that it be fully processed within that time, so an application filed near the end of the window still counts. Tell the insurer you are using Maryland's birthday rule; it cannot apply underwriting to the switch.
Keep the old policy until the new one starts
Don't cancel existing coverage until the new policy is confirmed and in force, so you're never uninsured.
Because the benefits inside a letter are standardized, a same-letter switch changes your premium and insurer, not your coverage. If you move to a lesser letter, your cost-sharing changes to match that letter.
Plan G and Plan N: the common choices
For someone newly eligible for Medicare, the practical choice in Maryland narrows to two plans.
Plan G is still available to people who became eligible for Medicare on or after January 1, 2020, the date Plans C and F closed to newcomers. It covers the same benefits as Plan F except the annual Part B deductible: the Part A hospital deductible, Part A and Part B coinsurance, skilled nursing facility coinsurance, and Part B excess charges. After you pay that one Part B deductible for the year, a Plan G holder generally has no further cost-sharing on Medicare-covered services in the United States. Foreign travel emergency care is the exception: Plan G covers it at 80% up to plan limits.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Jul 22, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
Plan N covers the same major gaps but shifts a little cost back to you. It pays the Part B coinsurance except for a copay of up to $20 for some office visits and up to $50 for emergency-room visits that don't lead to an inpatient admission, and it does not cover Part B excess charges. In exchange, Plan N premiums are usually lower than Plan G premiums.Centers for Medicare & Medicaid Services. (n.d.). Compare Medigap Plan Benefits. medicare.gov. Retrieved Jul 22, 2026, from https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
| Feature | Plan G | Plan N |
|---|---|---|
| Part A hospital deductible | Covered | Covered |
| Part B coinsurance | Covered in full | Covered, minus up to $20 office / $50 ER copays |
| Part B excess charges | Covered | Not covered |
| Annual Part B deductible ($283 in 2026) | You pay it | You pay it |
| Skilled nursing facility coinsurance | Covered | Covered |
| Relative premium | Higher | Lower than Plan G |
Plans C and F are closed to newer enrollees
Plans C and F once covered the annual Part B deductible on top of the other gaps, which made Plan F the most complete plan on the market. Under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), any Medigap plan that pays the Part B deductible is closed to people who first became eligible for Medicare on or after January 1, 2020.Centers for Medicare & Medicaid Services. (2026). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2026) - Medicare.gov. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
The closure works by eligibility date, not purchase date. If you became eligible for Medicare before January 1, 2020, you can still buy or keep Plan C or Plan F in Maryland. If you became eligible on or after that date, those two plans are off the table, which is why Plan G has become the default top-tier choice for newer enrollees: it's identical to Plan F except that you pay the one Part B deductible yourself.Centers for Medicare & Medicaid Services. (2026). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2026) - Medicare.gov. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
When you can buy or switch in Maryland
Maryland gives you more than one protected window. Three matter most.
- The federal Medigap Open Enrollment Period. This is a one-time, six-month window that begins the first month you're both age 65 or older and enrolled in Medicare Part B. During it, insurers must sell you any Medigap policy they offer regardless of your health, with no medical underwriting and no higher price because you have health problems. This is the single best time to buy, because you can choose any plan, including Plan G.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Aug 8, 2026, from https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf
- The annual birthday rule. The window described above, covering your birthday and the 30 days after it, repeating each year, for switching to an equal-or-lesser plan from any insurer without underwriting.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
- Federal guaranteed-issue rights. Certain life events, such as losing other coverage or an insurer leaving the market, trigger a federal guaranteed-issue right to buy specific plans without underwriting.
Outside these windows, a Maryland insurer can require medical underwriting and charge more, or decline to sell you a policy, based on your health. That's why the choice between Plan G and Plan N is best made during your six-month open enrollment: if you start on Plan N to save on premiums and later want Plan G, the birthday rule won't cover that move up, and underwriting could make it expensive or impossible.
What Medigap costs and how it's priced in Maryland
Medigap premiums vary widely. The benefits inside a letter are fixed, but the price is not: it depends on the insurer, your age, and in many cases your gender and tobacco use. Because these premiums are set by each carrier rather than by Medicare, a Plan G quote from one Maryland insurer can differ sharply from another's for the exact same coverage, which is why comparing carriers matters as much as choosing the plan letter.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Insurers use one of three pricing methods, which shapes how your premium changes as you age:
- Community-rated policies charge everyone the same premium regardless of age.
- Issue-age-rated policies base your premium on your age when you buy, and that starting point doesn't rise simply because you get older.
- Attained-age-rated policies start lower but increase as you age, so a low first-year quote can climb over time.
Ask which method each insurer uses, not just the first-year premium. The birthday rule pairs well with this: because you can switch to any insurer, if your attained-age policy climbs, the annual window lets you move an equal-or-lesser plan to a cheaper carrier without underwriting. Note that Medigap does not include prescription drug coverage, so you add a separate Part D plan for that.
Where to check Maryland's birthday-rule details
Maryland's birthday-rule guidance comes from the Maryland Insurance Administration, which sets out how the once-yearly period works, the annual notice insurers must send, and a chart pairing each existing plan with the plans that count as equal or lesser value. Medicare itself directs beneficiaries to their state insurance department to find out whether their state offers extra chances to change a Medigap policy, and in Maryland that department is the MIA, so its consumer pages at insurance.maryland.gov are where to check the chart for your own plan letter before you apply, or to follow up if you did not receive the required notice.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Frequently Asked Questions
How does the Maryland birthday rule work?
Maryland gives Medigap policyholders a once-yearly open enrollment period that includes their birthday and the 30-day period following it, during which they can change, without underwriting, to a Medigap policy of equal or lesser benefits from any insurer, per the Maryland Insurance Administration. The rule took effect July 1, 2023, and applies to policies issued in Maryland.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Will my insurer remind me about the Maryland birthday rule?
Yes. Maryland requires your insurer to mail you a notice of the switch right at least 30 days, but no more than 60 days, before your birthday. If you did not receive it, you can contact the Maryland Insurance Administration.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Can I switch to a different insurance company during the Maryland birthday window?
Yes. The Maryland birthday rule lets you switch to an equal-or-lesser plan from any insurer, not just your current company. Because the benefits inside a plan letter are identical across insurers, this is how Marylanders move comparable coverage to a lower-priced carrier once a year.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Can I still buy Plan F in Maryland?
Only if you first became eligible for Medicare before January 1, 2020. Plans C and F, which cover the Part B deductible, are closed to anyone who became eligible on or after that date under MACRA. Plan G is the closest available alternative; it's identical to Plan F except that you pay the annual Part B deductible yourself.Centers for Medicare & Medicaid Services. (2026). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2026) - Medicare.gov. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
Which plans count as equal or lesser value in Maryland?
The Maryland Insurance Administration publishes a chart pairing each existing plan with the plans that have lesser or equal value, so check that chart for your own plan letter. As a general test, a new policy counts as equal or lesser value unless it adds a significant benefit your current policy does not include, or keeps the same significant benefits while reducing your cost-sharing; the premium itself does not count as cost-sharing.Centers for Medicare & Medicaid Services. (n.d.). Can I switch or drop my Medigap policy?. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
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