If your Nevada Medigap premium just jumped, you have a yearly window to shop for a cheaper plan without a health screening.
In This Guide
- The Rule in Brief
- How Nevada's Birthday Rule Works
- What "Same or Lesser Benefits" Means
- What the Birthday Rule Will Not Do
- How to Use Your Window
- Frequently Asked Questions
How Nevada's Birthday Rule Works
Under Original Medicare, a Medigap policy fills the deductibles and coinsurance that Medicare leaves to you. The trade-off is that, outside the one-time federal Medigap Open Enrollment Period, insurers in most states can use medical underwriting to switch shoppers: they review your health, charge you more, or decline you outright. That makes it hard to leave a plan once your premium starts climbing.
Nevada is one of a handful of states that fixed this with a "birthday rule." Assembly Bill 250, passed in the 2021 legislative session and effective January 1, 2022, gives every existing Medicare Supplement policyholder a new open enrollment period each year.
Here is the shape of that window:
- It opens on the first day of your birthday month. If you were born in September, your window opens September 1.
- It stays open for at least 60 days after that first day.
- During the window, the replacement policy is guaranteed issue. An insurer cannot rate you up or deny you because of your health status or your claims experience.
You can switch to a plan from your current company or move to a different carrier entirely. The rule applies to all carriers with open blocks of business, so your choices are not limited to a single insurer.
| Detail | What the rule says |
|---|---|
| Who qualifies | Nevada residents who already hold a Medicare Supplement (Medigap) policy |
| When the window opens | The first day of your birthday month |
| How long it lasts | At least 60 days after it opens |
| What you can switch to | A plan with the same or lesser benefits, from your existing carrier or a new one |
| Underwriting | None; you cannot be rated up or denied based on health or claims history |
| Carrier notice | Your insurer must tell you about this right at least 30 to 60 days before the window |
Carriers are not allowed to keep this quiet. Under AB 250, your Medicare Supplement company must notify you of the birthday-rule right and give you at least a 30 to 60 day notice before your enrollment period. Watch your mail in the weeks before your birthday month so you do not miss the window.
What "Same or Lesser Benefits" Means
The birthday rule lets you move to a policy with the same or lesser benefits, not a richer one. In practice that means you can keep the same standardized plan letter (a Plan G holder moving to another company's Plan G) or step down to a plan that covers less. You cannot use the birthday rule to upgrade to a plan with more coverage than you have now.
One technical point matters when you compare plans: innovative benefits do not count in the "equal or lesser" comparison. Those are the extra perks some carriers attach to a standardized plan, so they are set aside when an insurer checks whether your new policy is truly the same or lesser.
What the Birthday Rule Will Not Do
AB 250 is powerful, but it is narrow on purpose. Three limits are worth knowing before you shop:
- You have to already have Medigap. The birthday rule is a switching right for current policyholders. It is not a way to buy your first Medicare Supplement plan after missing your federal open enrollment.
- You cannot upgrade benefits. As above, the replacement must have the same or lesser benefits.
- You cannot use it to re-enroll with the same company and the same plan just to move from a non-standard rate to a standard rate. AB 250 specifically does not allow that maneuver.
There is also a separate legal distinction. People using the AB 250 birthday rule are not treated as federal "eligible persons" for the guaranteed-issue protections under Nevada Administrative Code 687B.2056, which is a different set of rights triggered by events like losing employer coverage. The birthday rule stands on its own; do not assume it carries those federal protections with it.
How to Use Your Window
If a rate increase has you looking to switch, here is a practical sequence:
- Mark your window. It opens the first day of your birthday month and runs at least 60 days. Put both dates on your calendar.
- Compare plans of the same letter or lower. Decide whether you want to keep your current coverage level with a cheaper carrier or step down to a plan that covers less for a lower premium.
- Apply during the window. Because the new policy is guaranteed issue, the insurer cannot rate you up or deny you for your health.
- Confirm before you cancel. Make sure your new policy is active before you drop the old one so you are never without supplemental coverage.
For free, unbiased help reading your options, Nevada MAP/SHIP counselors walk through Medigap comparisons at no cost. You can find their contact details in our Nevada Medicare hub.
Frequently Asked Questions
It opens on the first day of your birthday month and stays open for at least 60 days after that date. If you were born in March, for example, your window opens March 1 and runs through at least the end of April. Your carrier must give you at least a 30 to 60 day notice before it begins.
No. The birthday rule lets you move to a Medicare Supplement plan with the same or lesser benefits only, not a richer one. You can keep your current plan letter with a different carrier or step down to a plan that covers less, but you cannot upgrade.
Yes. You can buy your new policy from your existing carrier or from a completely different one. The rule applies to all carriers with open blocks of business, so you are free to shop the market.
No. During your window the replacement policy is guaranteed issue, so the insurer cannot charge you more (rate you up) or deny you based on your health status or claims experience. The one thing the rule does not let you do is re-enroll with the same company and same plan just to move from a non-standard rate to a standard rate.
Learn More
- Medicare Plans and Coverage in Nevada
- How Medigap Works
- Medicare: The National Guide
- Original Medicare vs. Medicare Advantage
If a premium increase has you ready to switch, time your move to your birthday month and find free Nevada Medigap help at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.