Oregon's Medicare Supplement (Medigap) "birthday rule" gives policyholders one protected chance a year to switch plans, and the change is guaranteed regardless of their health. The window starts 30 days before your birthday and ends 30 days after it, and during it you can move to an equal-or-lesser Medigap plan sold by a different insurance company, a protection the state adopted in response to complaints about being locked into policies with large annual rate increases. This guide explains how Oregon's birthday rule works, how to use it, how the standardized lettered plans fit together, which plans are closed to newer enrollees, and where to get free help in the state.
How Medigap works in Oregon
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 separate 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
Oregon 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 Oregon 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.
The gaps Medigap closes are real. In 2026, after you meet the annual Part B deductible of $283, Original Medicare still leaves you 20% coinsurance on the approved amount for most outpatient care, with no annual cap. Part A adds an inpatient hospital deductible of $1,736 per benefit period in 2026, and because a new benefit period can begin more than once in a year, that deductible can apply more than once. 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 Oregon birthday rule
Oregon's annual protection is the birthday rule. It gives Medicare beneficiaries a yearly opportunity to compare Medicare Supplement prices and switch companies: the opportunity starts 30 days before your birthday and ends 30 days after your birthday, and during it you may move to a Medigap policy of the same plan type or one with lesser benefits, with the change guaranteed regardless of your health. Oregon's Division of Financial Regulation, whose birthday rule fact sheet is the source of these rules and is also hosted by Oregon SHIBA, describes the rule as a response to frequent consumer complaints of being locked into plans with large annual rate increases.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
The practical value is that you are not locked into your current insurer's price. Medigap benefits inside a letter are identical across companies, but premiums are not, and an insurer's rates can climb faster than a competitor's over time. The birthday rule lets you move your same Plan G (or any equal-or-lesser plan) to a lower-priced carrier once a year, with the change guaranteed regardless of your health. New coverage typically begins on the first of the month following the application date.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
One thing to be precise about, because it decides whether the switch actually saves you money. What Oregon's Division of Financial Regulation states is that the change is guaranteed regardless of your health, which is about whether an insurer must take you. Its guidance does not go on to say what premium the new insurer may quote you. So treat the birthday rule as protecting your ability to switch, and compare the actual quoted rates before you move: get a written quote from the new carrier for your specific age, ZIP code, and tobacco status, and compare it against what you pay now.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
The "same plan type 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. As Oregon's Division of Financial Regulation puts it, a 2010 Plan F enrollee can switch to any 2010 Medicare Supplement Plan A through N, except an Innovative Plan F. 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 Oregon birthday rule
The opportunity is time-limited and the timing rules are specific, so plan the switch before your birthday arrives. Oregon's birthday rule guarantees the change to a same-type-or-lesser plan from another company regardless of your health, so the work is mostly timing and comparison.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
Know your dates
The window opens 30 days before your birthday and closes 30 days after it. Shop and compare quotes in the weeks before it opens so you can act as soon as it does.
Confirm the new plan is the same type 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; a Plan N holder can switch to another Plan N or a lesser letter.
Apply during the window
Submit the application between 30 days before and 30 days after your birthday, and tell the insurer you are using Oregon's birthday rule. The change is guaranteed regardless of your health.
Keep the old policy until the new one starts
New coverage typically begins the first of the month after you apply, so don't cancel existing coverage until the new policy is confirmed and in force. That way 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 Oregon 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. (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
Plan N covers the same major gaps but shifts a little cost back to you. It pays the Part B coinsurance in full 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 were eligible for Medicare before January 1, 2020 but haven't yet enrolled, you may still be able to buy Plan C or Plan F in Oregon, and if you already hold one you don't have to switch: any Medigap policy issued since 1992 is guaranteed renewable, so the insurer can't cancel it as long as you stay enrolled and pay the premium. 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.
When you can buy or switch in Oregon
Oregon 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. One limit applies even here: the insurer can still refuse to cover your out-of-pocket costs for a pre-existing condition for up to 6 months, though it can't impose that wait if you've had at least 6 months of continuous prior creditable coverage. This is still the single best time to buy, because you can choose any plan, including Plan G. Read more about the Medigap Open Enrollment Period.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 yearly window described above, running from 30 days before your birthday to 30 days after it, for switching to an equal-or-lesser plan from another company with the change guaranteed regardless of your health.
- 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, an Oregon 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 Oregon
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, and CMS does not set Medigap premiums. There is no single Oregon rate, so compare quotes for the same plan letter across several carriers.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, described in the medicare.gov guide Choosing a Medigap Policy, 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, and it is exactly the problem Oregon designed the rule to solve: if your attained-age policy climbs, the annual window lets you move an equal-or-lesser plan to a cheaper carrier, guaranteed regardless of your health. Note that Medigap does not include prescription drug coverage, so you add a separate Part D plan for that.
Where to get help with Medigap in Oregon
Oregon's State Health Insurance Benefits Assistance program, Oregon SHIBA, is a statewide network of trained counselors who volunteer their time to educate and advocate for people of all ages who have Medicare. The program is part of the Oregon Department of Human Services and offers Medicare information and counseling services as a free public service, covering Medigap plans, Medicare Advantage plans, prescription drug plans, and financial help. Its statewide helpline is 1-800-722-4134.shiba.oregon.gov. (n.d.). Get Help - Oregon SHIBA, Oregon Department of Human Services. Retrieved Jul 30, 2026, from https://shiba.oregon.gov/get-help/Pages/shiba-help.aspx
The birthday rule itself comes from a fact sheet published by Oregon's Division of Financial Regulation, hosted on both the SHIBA and DFR sites, and that fact sheet tells consumers with questions to contact their insurance agent or SHIBA at the same number.Centers for Medicare & Medicaid Services. (n.d.). When can I buy a Medigap policy?. medicare.gov. Retrieved Jul 30, 2026, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
Frequently Asked Questions
How does the Oregon birthday rule work?
Oregon gives Medigap policyholders a yearly opportunity to compare prices and switch companies, starting 30 days before their birthday and ending 30 days after it. You may move to a Medigap policy of the same plan type or one with lesser benefits, and the change is guaranteed regardless of your health. The rule applies only to policies issued after January 1, 1990, and Oregon adopted it in response to complaints about being locked into plans with large annual rate increases.
Can I switch to a different insurance company during the Oregon birthday window?
Yes. The Oregon birthday rule is explicitly an opportunity to switch companies, to a same-type-or-lesser plan, not just to a different policy from your current insurer. Because the benefits inside a plan letter are identical across insurers, this is how Oregonians move comparable coverage to a lower-priced carrier once a year.
Can I use the Oregon birthday rule to upgrade from Plan N to Plan G?
No. The birthday rule only lets you switch to a plan with the same plan type or lesser benefits. Moving up to a more comprehensive plan, such as Plan N to Plan G, is not covered and would require medical underwriting outside a guaranteed-issue window. To get Plan G without underwriting, choose it during your six-month open enrollment.
Can I still buy Plan F in Oregon?
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.
Where can I get free help with Medigap in Oregon?
Oregon SHIBA, the state's Senior Health Insurance Benefits Assistance program, is part of the Oregon Department of Human Services and offers Medicare information and counseling services as a free public service through a statewide network of trained counselors. Its helpline is 1-800-722-4134. Oregon's Division of Financial Regulation publishes the birthday rule fact sheet that sets out the switching rules above.
Learn More
Ready to act? If your birthday window is coming up, call Oregon SHIBA at 1-800-722-4134 for free help comparing Medigap plans, or start at Oregon SHIBA.shiba.oregon.gov. (n.d.). Get Help - Oregon SHIBA, Oregon Department of Human Services. Retrieved Jul 30, 2026, from https://shiba.oregon.gov/get-help/Pages/shiba-help.aspx
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.