Utah Medigap: Open Enrollment, Guaranteed Issue, Under 65 (2026)

Utah Medigap rules give you one six-month window, starting the first month you are both 65 and on Medicare Part B, to buy any Medigap policy an insurer offers at its lowest rate. Under Utah rule R590-146-11, a Medigap (Medicare Supplement) insurer in Utah cannot deny you, condition the sale, or price the policy on your health during that window, and it must offer the lowest rate available without regard to health or smoker status.1 Outside that window, Utah's rule R590-146-12 guarantees a Medigap sale only in listed situations, such as an employer plan ending, a Medicare Advantage plan leaving your area, or an involuntary loss of Medicaid, and most of those rights run on 63-day deadlines.1

In This Guide

• When Is Your One-Time Medigap Open Enrollment Window in Utah?
• How Do Pre-Existing Conditions Work in a Utah Medigap Policy?
• Can You Buy Medigap in Utah If You're Under 65?
• When Do Utah Medigap Guaranteed-Issue Rights Apply?
• Which Medicare Supplement Plans Can You Buy in Utah?
• Can You Keep or Replace a Utah Medigap Policy?
• Should You Pick Medigap or Medicare Advantage in Utah?
• What Are Utah's Medigap Windows at a Glance?
• Where Can You Get Medigap Help in Utah?
• Frequently Asked Questions
• Learn More

When Is Your One-Time Medigap Open Enrollment Window in Utah?

Utah's Medigap open enrollment rule is Utah Admin. Code R590-146-11, part of the Utah Insurance Department's Medicare supplement rule R590-146 (the current rule took effect September 29, 2025). The Utah Medigap open enrollment window is six months long and begins on the first day of the first month in which you are both 65 or older and enrolled in Medicare Part B.1

For a Medigap application covered by the Utah open enrollment rule, R590-146-11 says the insurer may not:

• deny or condition the issuance or effectiveness of any Medigap policy it has available for sale in Utah;
• discriminate in the price of the policy because of your health status, claims experience, receipt of health care, or medical condition.

Utah's rule adds two protections that go further than a bare no-underwriting promise. Under R590-146-11, each Medigap policy a Utah insurer currently has available must be available to an open enrollment applicant regardless of age, and during open enrollment the insurer must offer the lowest rate available without regard to health or smoker status.1

Federal law sets the same basic floor nationwide. Section 1882 of the Social Security Act, at §1882(s)(2)(A), bars a Medigap issuer from denying, conditioning, or pricing a policy on health for an applicant during the six months beginning with the first month the person is 65 or older and enrolled in Part B. Medicare.gov calls the federal Medigap Open Enrollment Period a one-time enrollment period that doesn't repeat every year.4

Once the Utah window closes, the price of waiting shows up quickly. Medicare.gov warns that outside the Medigap Open Enrollment Period you may have to pay more for a policy, fewer policy options may be available, and an insurance company is allowed to deny you a policy if you don't meet its medical underwriting requirements.4 Brevy's guide to the Medigap open enrollment period covers the federal timing in more detail.

How Do Pre-Existing Conditions Work in a Utah Medigap Policy?

A guaranteed sale during Utah open enrollment doesn't always mean immediate coverage for a condition you already have. Whether a Utah Medigap policy can make you wait depends on your prior creditable coverage.

• Six months or more of creditable coverage: under Utah rule R590-146-11, a Medigap insurer may not exclude benefits based on a pre-existing condition if an open enrollment applicant has had a continuous period of creditable coverage of at least six months.
• Less than six months of creditable coverage: the Utah insurer must shorten the pre-existing-condition exclusion period by the total time of creditable coverage the applicant has had.1

Utah rule R590-146-11 also says its open enrollment protection does not prevent a Medigap policy from excluding benefits, during the first six months, for a pre-existing condition.1

Utah's Medicare supplement statute caps how far any such wait can reach. Under Utah Code 31A-22-620(3)(b), a Utah Medigap policy may not exclude or limit benefits for a loss incurred more than six months after coverage takes effect because the loss involved a pre-existing condition. The same Utah statute limits what can count as pre-existing: a Utah Medigap policy may not define a pre-existing condition more restrictively than a condition for which a physician gave medical advice, or recommended or provided treatment, within six months before coverage began.1

If you are leaving employer coverage or another plan, ask the insurer how it counts your creditable coverage before you sign. Brevy's guide to Medigap and pre-existing conditions walks through the federal mechanics.

Can You Buy Medigap in Utah If You're Under 65?

Utah's Medigap open enrollment protection is tied to age 65. Utah rule R590-146-11 applies to applications connected with the six months beginning with the first month a person is both 65 or older and enrolled in Medicare Part B.1

The Utah Insurance Department's Medicare page warns that a person might not be able to buy a Medigap policy if the person is under 65 and disabled or has End-Stage Renal Disease (ESRD). The Utah Insurance Department's page carries guidance from the Centers for Medicare & Medicaid Services (CMS) that no federal law requires insurance companies to sell Medigap policies to people under 65, although some state laws are more generous than federal law.1

CMS's Medigap guide lists the states that, at the time of printing, require insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65, and Utah is not on the CMS list. The same CMS guide says that even in a state not listed, some insurance companies may voluntarily sell Medigap policies to people under 65, although those policies will probably cost more and probably use medical underwriting.1

For a Utahn on disability Medicare, age 65 still brings the open enrollment window. The Utah Insurance Department's Medicare page states that all plans are available on a guaranteed issue basis to a person who is 65, already on Medicare Part B, and requesting the coverage within six months of turning 65.1 If you are under 65, ask Utah's Senior Health Insurance Program (SHIP) counselors which insurers currently accept applications before you rely on a Medigap policy.

When Do Utah Medigap Guaranteed-Issue Rights Apply?

Medicare.gov notes that its switching answers cover only federal rights, and that in most cases you won't be able to switch your Medigap policy outside your six-month Medigap Open Enrollment Period except in specific situations when you have a guaranteed-issue right.5 Utah's guaranteed-issue situations are set by Utah Admin. Code R590-146-12.

For an eligible person who applies during the Utah guaranteed-issue period, R590-146-12 bars a Medigap insurer from denying or conditioning a covered policy it offers to new enrollees, from pricing that policy on health status, claims experience, receipt of health care, or medical condition, and from imposing a pre-existing-condition exclusion.1

Which Utah situations create a guaranteed-issue right

Utah rule R590-146-12 makes a person eligible for a guaranteed-issue Medigap policy in these situations, among others:1

• Employer plan ends: your employee welfare benefit plan that supplements Medicare terminates or stops providing all of its supplemental health benefits to you.
• Medicare Advantage plan ends or you move: your Medicare Advantage plan's certification is terminated, the organization stops offering the plan where you live, or you are no longer eligible for the plan because of a move or another change in circumstances. The Utah rule gives parallel treatment to a person 65 or older enrolled with a Program of All-Inclusive Care for the Elderly (PACE) provider.
• Medigap insurer fails: your Medigap coverage ends because of the insurer's insolvency or bankruptcy, or because of another involuntary termination.
• Trial after dropping Medigap: you dropped a Medigap policy to join a Medicare Advantage plan, a PACE provider, or a Medicare SELECT policy for the first time, and you end that new enrollment within the first 12 months.
• Trial at 65: upon first becoming eligible for Medicare Part A at age 65, you enrolled in a Medicare Advantage plan or with a PACE provider, and you disenroll within 12 months after the enrollment took effect.
• Medicaid ends involuntarily: you were enrolled in Utah Medicaid (Title XIX) and are involuntarily terminated outside the rule's separate Medicaid premium-suspension provisions.

To prove eligibility, Utah rule R590-146-12 requires the applicant to submit evidence of the date of termination, disenrollment, or Medicare Part D enrollment with the Medigap application.1

How long each Utah guaranteed-issue window lasts

Utah rule R590-146-12 gives each situation its own start date, and every Utah guaranteed-issue period ends 63 days after a set point:1

• Employer plan ending, or a Medigap insurer's insolvency or other involuntary termination: the Utah window lasts 63 days, starting on the later of the termination notice or the date coverage ends.
• Involuntary loss of a Medicare Advantage or PACE plan, including a trial enrollment: the Utah window begins on the date you receive the termination notice and ends 63 days after the coverage terminates.
• Voluntary disenrollment from a Medicare Advantage or PACE plan in one of the listed situations: the Utah window begins 60 days before the disenrollment takes effect and ends 63 days after it.
• Medicaid involuntary termination: Utah's rule does not give the Medicaid situation a clock of its own, so it falls under the rule's catch-all for any eligible person not otherwise described, which begins on the effective date of disenrollment and ends 63 days later.

Missing a Utah 63-day deadline can put you back into the medical underwriting that Medicare.gov warns about outside the Medigap Open Enrollment Period, described in the open enrollment section above.4 Keep every termination or disenrollment notice, and apply as soon as you learn your coverage is ending.

Which policy a Utah trial right lets you buy

The two Utah trial rights lead to different policies. Under Utah rule R590-146-12, a person who dropped a Medigap policy for a first-time Medicare Advantage, PACE, or Medicare SELECT enrollment and leaves within 12 months is entitled to the same policy most recently held, if the same insurer still offers it. If the insurer that sold that person's previous Medigap policy no longer offers it, Utah rule R590-146-12 entitles a person leaving a first-time Medicare Advantage, PACE, or Medicare SELECT enrollment within 12 months to a policy from the rule's standard guaranteed-issue list instead.1

A person who joined Medicare Advantage or PACE upon first becoming eligible for Part A at age 65 and leaves within 12 months is entitled, under Utah rule R590-146-12, to any Medigap policy offered by any insurer.1

Plan choices under Utah's other guaranteed-issue situations depend on the situation, so confirm which lettered plans an insurer must sell you with Utah's SHIP before you apply. Brevy's guides to Medigap guaranteed-issue rights and to switching between Medicare Advantage and Original Medicare cover the federal side.

Which Medicare Supplement Plans Can You Buy in Utah?

Medigap plans are standardized by letter. Medicare's 2026 guide Choosing a Medigap Policy charts the Medigap plans as Plans A, B, C, D, F, G, K, L, M and N, and states that every insurance company that sells Medigap policies must offer at least Medigap Plan A.2

Medigap plans sold to people new to Medicare on or after January 1, 2020 aren't allowed to cover the Part B deductible, so Medigap Plans C and F are no longer available to people new to Medicare. Utahns new to Medicare on or after that date have the right to buy Medigap Plans D and G instead, which give the same benefits but don't cover the Part B deductible.2

Medigap Plans E, H, I and J are no longer sold, but someone who already has one of those older Medigap plans can generally keep it.2 Brevy's guides to how the lettered Medigap plans work and to whether you can still get Medigap Plan F compare the letters benefit by benefit.

Can You Keep or Replace a Utah Medigap Policy?

Utah Medigap coverage is hard for an insurer to take away. Under Utah rule R590-146-8a, a Medigap policy with coverage effective on or after June 1, 2010 must be guaranteed renewable, and the insurer may not cancel or nonrenew it solely because of your health status or for any reason other than nonpayment of premium or material misrepresentation.1

Every new Utah Medigap policy comes with a return period. Utah Code 31A-22-620(6) requires each Medigap policy to carry a prominent notice that the applicant may return it within 30 days of delivery and have the premium refunded if not satisfied for any reason.1

Replacing one Utah Medigap policy with another doesn't restart the clock on time you've already served. Under Utah rule R590-146-23, the replacing insurer must waive pre-existing-condition, waiting, elimination, and probationary periods to the extent the time was spent under the original policy. If the original Utah Medigap policy was in effect for at least six months, the replacing policy may not impose any such period for a benefit similar to one in the original policy.1

Getting accepted for the replacement is a separate question from those waivers. Medicare.gov warns that if you switch Medigap policies outside your Medigap Open Enrollment Period, you may have to pay more for the new policy and answer some medical questions, unless you have a guaranteed-issue right.5 Keep your current Utah policy in force until the new insurer approves you.

Should You Pick Medigap or Medicare Advantage in Utah?

Medigap works only alongside Original Medicare. The CMS booklet Understanding Medicare Advantage Plans states that you can't use a Medigap policy to pay Medicare Advantage Plan copayments, coinsurance, deductibles, and premiums.6

The same CMS booklet states that if you're in a Medicare Advantage Plan, it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. If you aren't planning to drop Medicare Advantage and someone tries to sell you a Medigap policy, the CMS booklet says to report it to your State Insurance Department.6 Brevy's guide to illegal Medigap sales to Medicare Advantage members explains how the practice works.

Dropping a Medigap policy to join Medicare Advantage is hard to undo. The CMS booklet states that in most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you may not be able to get the same policy back, which is why the two Utah trial rights above matter.6

What Are Utah's Medigap Windows at a Glance?

The table summarizes Utah rules R590-146-11 and R590-146-12; the sections above give the exact conditions for each Utah Medigap window.1

Where Can You Get Medigap Help in Utah?

The Utah Insurance Department lists Utah's Senior Health Insurance Program (SHIP) at (877) 424-4640 or (801) 538-3910. The Utah Insurance Department also lists its own Consumer Analyst team at (801) 957-9280 and the Utah Division of Aging and Adult Services at (800) 371-7897.3

To compare Medigap prices, the Utah Insurance Department points readers to medigap.utah.gov, where Utahns can compare annual Medigap premiums between insurance companies.3 Utah's Medicare hub covers the rest of Medicare in the state, and Utahns with limited income can check Utah's Medicare Savings Programs for help with Part B costs.

For questions about Original Medicare itself, 1-800-MEDICARE (1-800-633-4227) is the official Medicare line run by CMS, and TTY users call 1-877-486-2048. Medicare.gov says 1-800-MEDICARE callers can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays.7

Learn More

Find personalized help timing your Utah Medigap window and checking a guaranteed-issue right 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.