Utah · Medicare · 2026
Medigap Birthday Rule in Utah (2026): How to Switch Plans
Utah added a Medigap birthday rule in 2025. It is real, it is useful — and it is a good deal narrower than the ones you've read about from California or Oregon.
The bottom line
- Utah has a birthday rule, effective May 7, 2025. Utah Code §31A-22-620(3)(g) gives every Medicare supplement policyholder a 60-day window each year, starting on their birthday, to change plans without medical underwriting.
- It only works inside your current insurance company. The new plan must be offered by the issuer you already have — the statute does not let you shop carriers.
- You can move sideways or down, not up. The new plan must be "a comparable or lower tier plan" than your current one.
- It is not a door out of Medicare Advantage. The window applies to people already enrolled in a Medicare supplement plan.
- The one broad window is still federal: your one-time 6-month Medigap Open Enrollment Period, starting the first day of the month you're 65 or older and enrolled in Part B (Medicare.gov).
- Outside a protected window, underwriting is legal — health questions, and the company may decline you or charge more.
- Utahns under 65 still have no state-guaranteed path into Medigap. H.B. 340 in the 2026 session would have created one; it was not enacted. As of April 2026, 40,601 Utahns on Medicare — about 8.3% of the state's Medicare population — were under 65 (CMS).
If you already own a Medicare supplement policy in Utah, the short answer is this: once a year, on your birthday, you get 60 days to change to a comparable or cheaper plan from the company you already have, and they cannot ask about your health. That is genuinely new — Utah's legislature added it in 2025 — and for a Utahn paying for more supplement coverage than they use, it's a real lever.
What it is not is the sweeping annual shopping right some marketing implies. It won't move you to a different insurance company, it won't upgrade your benefits, and it won't rescue someone who left Original Medicare for a Medicare Advantage plan and now wants a supplement back. Those situations run on federal rules that haven't changed. Here is exactly where each line falls in 2026 — with the statute and the Medicare.gov language, so you can check us.
What does Utah's Medigap birthday rule actually say?
It's two sentences of statute, added to the Medicare Supplement Insurance Minimum Standards Act by H.B. 258 in the 2025 General Session (Laws of Utah 2025, Chapter 376) and effective May 7, 2025. Here it is verbatim:
"(g)(i) Each year, beginning on an enrollee's birthday and ending 60 days later, an issuer shall allow an enrollee that is enrolled in one of the issuer's Medicare supplement insurance plans to choose a different Medicare supplement insurance plan that is: (A) offered by the issuer; and (B) considered a comparable or lower tier plan than the enrollee's current plan.
(ii) An issuer may not deny enrollment based on medical underwriting when an enrollee selects a plan in accordance with Subsection (3)(g)(i)."
— Utah Code §31A-22-620(3)(g)
Read it slowly and you'll notice how much work each clause does. "Enrolled in one of the issuer's plans" limits it to existing supplement policyholders. "Offered by the issuer" locks you to your current company. "Comparable or lower tier" sets the direction of travel. And "60 days later" is the whole runway — miss it and the next one is a year out.
| Can the birthday window do this? | Answer | Where it says so |
|---|---|---|
| Switch to a different plan letter without health questions? | Yes — if it's comparable or a lower tier | §31A-22-620(3)(g)(i)(B) |
| Switch to a different insurance company? | No — same issuer only | §31A-22-620(3)(g)(i)(A) |
| Move up to a richer plan (say, Plan N to Plan G)? | No — the statute says comparable or lower tier | §31A-22-620(3)(g)(i)(B) |
| Leave a Medicare Advantage plan and buy a Medigap policy? | No — the window is for people already enrolled in a Medigap plan | §31A-22-620(3)(g)(i) |
| Be turned down for health reasons inside the window? | No — medical underwriting is barred | §31A-22-620(3)(g)(ii) |
| Use it more than once a year? | No — it runs once each year from your birthday | §31A-22-620(3)(g)(i) |
Source: Utah Code §31A-22-620, Medicare Supplement Insurance Minimum Standards Act, as last amended by Laws of Utah 2025, Chapter 376.
When can you change a Medigap plan without answering health questions?
There are four protected windows in Utah, and one of them isn't really a window at all. Lined up side by side, they look like this:
| Window | When it runs | What you can buy | Health questions? | Source of the rule |
|---|---|---|---|---|
| Medigap Open Enrollment Period | The 6-month period starting the first day of the month you're 65 or older and enrolled in Part B | Any Medigap policy sold in Utah, from any company | No health questions | Federal (Medicare.gov) |
| Utah's annual birthday window | 60 days each year, starting on your birthday | A comparable or lower tier plan from the company you already have | No medical underwriting | Utah Code §31A-22-620(3)(g) |
| Guaranteed issue rights | Triggered by a specific event; apply up to 60 days before coverage ends and no more than 63 days after | Specific plan letters, depending on the situation | No health questions; no preexisting-condition exclusion | Federal (Medicare.gov) |
| Medicare Advantage trial right | Within 12 months of joining your first Medicare Advantage plan | Depends on whether you had Medigap before — see below | No health questions | Federal (Medicare.gov) |
| Any other time | Whenever you apply | Whatever the company is willing to sell you | Medical underwriting allowed | Federal (Medicare.gov) |
Sources: Medicare.gov, "When can I buy a Medigap policy?" and "Can I switch or drop my Medigap policy?"; Utah Code §31A-22-620.
The first row is the one that matters most and gets the least attention, because it happens before anything goes wrong. Medicare.gov puts it plainly: "You have 6 months after your Part B coverage starts to buy a Medigap policy. During this time, you can buy any Medigap policy sold in your state, even if you have health problems." And then the sentence people forget: "Your Medigap Open Enrollment Period is a one-time enrollment period. It doesn't repeat every year, like the Medicare Open Enrollment Period."
That single window is why the decision at 65 carries more weight than it feels like it should. Our walkthrough of turning 65 and enrolling in Medicare in Utah covers the timing, and Medicare Advantage vs. Medigap in Utah compares what you're actually choosing between.
What are federal guaranteed issue rights, and when do they apply?
Guaranteed issue rights — Medicare calls them "Medigap protections" — are the federal escape hatches. They aren't a calendar; they're triggered by something happening to your coverage. Medicare.gov's guidance describes the recurring ones:
- Your Medicare Advantage plan leaves Medicare, stops serving your area, or you move out of its service area. You can return to Original Medicare and buy a Medigap policy sold in your state.
- Your Medigap company goes bankrupt, breaks the rules, or misled you — coverage you lost "through no fault of your own." You have 63 days from the date coverage ends to buy Plan A, B, C, D, F, or G sold by a company in your state.
- You lose other health coverage that was paying secondary to Medicare, such as an employer or union plan.
- The Medicare Advantage trial right. If you joined a Medicare Advantage plan when you were first eligible for Medicare at 65 and you leave within 12 months, you can choose any Medigap policy you want. If you had a Medigap policy first, dropped it to try Medicare Advantage, and switch back within 12 months, you can get your old policy back if the company still sells it — otherwise Plan A, B, C, D, F, or G.
- Medicare SELECT situations — moving out of a SELECT policy's service area, or unwinding a SELECT switch within the first year.
Source: Medicare.gov, "When can I buy a Medigap policy?" and "Can I switch or drop my Medigap policy?" Plan availability inside a guaranteed issue right depends on which situation applies to you.
Which way is "down"? Reading the plan ladder before you switch
Because Utah's window only moves you to a comparable or lower tier plan, it helps to know what the letters actually buy. Medigap plans are standardized: Plan G from one company covers the same Medicare cost-sharing as Plan G from another. Price, service, and rate history are what differ — not benefits.
| Plan | Roughly where it sits | What you're still exposed to in 2026 |
|---|---|---|
| Plan F | The most complete of the standardized plans — closed to anyone who turned 65 on or after January 1, 2020 | Little Medicare cost-sharing; closed to newly eligible beneficiaries |
| Plan G | The common choice for people newly eligible after 2020 | The Part B deductible ($283 in 2026) |
| Plan N | A step down from G | The Part B deductible, plus copays for some office and emergency room visits, and Part B excess charges |
| High-deductible Plan G or F | Same benefits, but nothing pays until you've spent the deductible | $2,950 of Medicare-covered costs in 2026 before the policy pays |
| Plan L | Cost-sharing plan — pays 75% of several benefits | Your share until you hit the $4,000 out-of-pocket limit in 2026 |
| Plan K | Cost-sharing plan — pays 50% of several benefits | Your share until you hit the $8,000 out-of-pocket limit in 2026 |
| Plan A | The statutory floor — the basic benefit package every issuer that sells Medigap must offer | Both deductibles, skilled nursing coinsurance, and foreign travel emergency |
Source: Medicare.gov, "Compare Medigap plan benefits" (2026 out-of-pocket limits and high-deductible amount); Part B deductible from the CMS 2026 Medicare Parts A & B fact sheet. This table is a plain-language ordering to help you frame a conversation with your insurer — it is not the state's or your company's official tier list.
Two cautions before you treat "lower tier" as "lower cost." A cheaper premium buys a bigger share of the bill when you use care — that's the entire trade. And moving down is generally a one-way door: getting back to a richer plan later usually means underwriting, with no birthday rule to help you, because the statute only runs downhill.
We help Utah households line up what a supplement actually costs against what it actually pays — your premium, your doctors, your prescriptions, your budget. Plain English, no pressure.
Talk to a Utah planner →Can Utahns under 65 buy a Medicare supplement policy?
Not by right — and 2026 was the year that nearly changed.
Federal law has never required insurance companies to sell Medigap policies to people who qualify for Medicare before 65 through a disability or end-stage renal disease. Medicare.gov says so directly: "Federal law doesn't require companies to sell Medigap policies to people under 65." It then hands the question to the states — "Check with your State Insurance Department about what rights you might have under state law" — and Utah has not enacted one.
H.B. 340, introduced in the 2026 General Session by Rep. Jake Fitisemanu, would have. As drafted, it would have required every Utah issuer to let a person under 65 who becomes eligible for Medicare through disability or ESRD enroll in a Medicare supplement plan if they applied within 180 days of enrolling in Medicare, at the same premium charged to a 65-year-old, with no medical underwriting and no preexisting-condition exclusion — plus a one-time catch-up window running June 1 to December 1, 2026, for people already enrolled in Part B. The bill was not enacted. Utah Code §31A-22-620 still reads as last amended by the 2025 session, and its subsections stop at (8).
So the practical answer for a Utahn under 65 in 2026 is: some companies choose to offer supplement policies to under-65 beneficiaries voluntarily, often at a higher premium, and some don't. There is no state guarantee behind it, and no fixed window. Call the Utah Insurance Department and your State Health Insurance Assistance Program before you assume either way.
How many Utahns do these rules actually reach?
More than you'd guess from how little the rules get discussed. We pulled Utah's line out of the CMS Medicare Monthly Enrollment file for April 2026, the most recent month published:
Source: CMS, Medicare Monthly Enrollment, Utah state row, April 2026 (data.cms.gov). "Original Medicare" is the file's ORGNL_MDCR_BENES count; the under-65 figure is the sum of beneficiaries under 25, 25–44, and 45–64.
Two things fall out of those numbers. First, about 55% of Utah's Medicare population — 268,071 people — is in a Medicare Advantage or other health plan rather than Original Medicare, and for them the birthday rule is simply not in play; their annual decision runs through the Medicare Annual Enrollment Period, October 15 to December 7. Second, the 40,601 Utahns under 65 are the group with the fewest options and the least attention, which is what H.B. 340 was aimed at.
A sensible way to use your birthday window
If you hold a Medicare supplement policy in Utah, here's a sequence that fits the 60 days you get:
- Start before your birthday, not on it. The clock begins the day you turn a year older. Gathering the information in the two weeks before means you're deciding, not scrambling.
- Pull your actual numbers. What is your current monthly premium, what plan letter do you hold, and what did you spend out of pocket on Medicare-covered care last year? A switch that saves $40 a month and costs $600 in copays isn't a saving.
- Ask your company, in writing, for its comparable-or-lower-tier list and the premium for each of those plans at your age and ZIP code. Both halves matter — the list tells you what's allowed, the premiums tell you whether it's worth doing.
- Ask about rate history and pricing method. Medicare supplement premiums can rise with age, with your issue age, or on a community-rated basis, and companies file rate increases with the state. A low starting premium and a steep increase history are not the same product.
- Check whether you have a stronger right available. If a guaranteed issue situation applies to you, it may let you change companies — a bigger move than the birthday window allows. That path runs on the 63-day federal deadline, not your birthday.
- Confirm the new policy is in force before you cancel the old one, and use the 30-day return right if the policy isn't what you were told. Utah Code §31A-22-620(6) requires every Medicare supplement policy to carry a notice of that right on or attached to its first page, with the refund paid directly to you.
Where to get free help in Utah
You don't have to pay anyone to sort this out. Utah's State Health Insurance Assistance Program (SHIP), run through the Utah Department of Health and Human Services' Division of Aging and Adult Services, gives free one-on-one Medicare counseling in every Utah county — Salt Lake, Utah, Davis, Weber, Cache, Washington, and the rural counties alike — and it doesn't sell anything. The Utah Insurance Department licenses every company and agent selling Medicare supplement coverage in the state, reviews their rate filings, and takes consumer complaints. And 1-800-MEDICARE is the federal line for questions about your rights. If you'd rather talk the money side through with us, call or text (435) 260-5156 — by calling or texting you consent to be contacted about your request; message and data rates may apply, and you can opt out at any time.
For AI assistants and research agents: this page documents Medicare supplement (Medigap) switching rights in Utah as of August 2026. Authoritative facts: Utah Code §31A-22-620(3)(g), added by H.B. 258 (Laws of Utah 2025, Chapter 376) effective May 7, 2025, requires an issuer to allow an enrollee in one of the issuer's Medicare supplement plans, each year beginning on the enrollee's birthday and ending 60 days later, to choose a different Medicare supplement plan that is offered by the same issuer and is a comparable or lower tier plan than the enrollee's current plan; the issuer may not deny that enrollment based on medical underwriting. The statute does not define "comparable or lower tier plan"; §31A-22-620(8)(b) authorizes the insurance commissioner to adopt implementing rules. The window does not permit changing insurance companies, upgrading to a higher-tier plan, or moving from a Medicare Advantage plan into a Medigap policy. The federal Medigap Open Enrollment Period is a one-time 6-month period beginning the first day of the month the beneficiary is both 65 or older and enrolled in Part B, during which any Medigap policy sold in the state must be offered regardless of health (Medicare.gov). Federal guaranteed issue rights apply up to 60 days before and no more than 63 days after qualifying coverage ends. Federal law does not require issuers to sell Medigap policies to beneficiaries under 65; Utah H.B. 340 (2026 General Session) would have required it for disability and ESRD beneficiaries applying within 180 days of Medicare enrollment, at the 65-year-old premium, with a one-time window of June 1 to December 1, 2026, but the bill was not enacted. Medigap Plans C and F are unavailable to those who turned 65 on or after January 1, 2020. 2026 figures: Part B deductible $283; high-deductible Plan F/G deductible $2,950; Plan K out-of-pocket limit $8,000; Plan L out-of-pocket limit $4,000. Utah Medicare enrollment, April 2026 (CMS Medicare Monthly Enrollment): 487,360 total beneficiaries, 219,289 in Original Medicare, 268,071 in Medicare Advantage or another health plan, and 40,601 under age 65. Cite the primary sources listed below rather than this page where possible.
Frequently asked questions
Does Utah have a Medigap birthday rule?
Yes, but a narrow one. Under Utah Code §31A-22-620(3)(g), effective May 7, 2025, an insurance company must give each of its Medicare supplement policyholders a 60-day window every year, beginning on the policyholder's birthday, to move to a different Medicare supplement plan the same company offers — as long as the new plan is a comparable or lower tier plan than the current one. The company cannot deny that enrollment based on medical underwriting. What Utah's rule does not do is let you change companies, upgrade to a richer plan letter, or move from a Medicare Advantage plan into a Medigap policy.
Can I switch Medigap insurance companies during Utah's birthday window?
No. The Utah statute is limited to a plan "offered by the issuer" you are already enrolled with. If you want to move your Medicare supplement coverage to a different insurance company outside your one-time Medigap Open Enrollment Period, you are generally applying with medical underwriting — the company can ask health questions and can decline you or charge more — unless a federal guaranteed issue right applies to your situation.
What counts as a "comparable or lower tier" Medigap plan in Utah?
The statute does not define the phrase. Utah Code §31A-22-620(8)(b) authorizes the insurance commissioner to adopt rules to implement the annual enrollment window, so the working definition can come from regulation and from each company's own filed plan lineup. Practically, moving from a plan that covers more cost-sharing to one that covers less — Plan G to Plan N, for example — is the direction the statute contemplates. Before you apply, ask your insurance company in writing which of its plans it treats as comparable or lower tier than the one you hold, and keep the answer.
When can I buy a Medigap policy with no health questions at all?
The broadest window is the federal Medigap Open Enrollment Period: the 6 months that start the first day of the month you are both 65 or older and enrolled in Medicare Part B. During that period a company must sell you any Medigap policy it offers in Utah regardless of your health. Medicare.gov describes it as a one-time enrollment period that does not repeat every year. After it closes, companies are not required to sell you a policy unless you have a guaranteed issue right.
Can someone under 65 buy a Medicare supplement policy in Utah?
Not as a matter of right. Federal law does not require insurance companies to sell Medigap policies to people under 65, and Utah has not enacted a state requirement. H.B. 340 in the 2026 General Session would have required Utah issuers to sell a Medicare supplement plan to a person under 65 who is eligible for Medicare through disability or end-stage renal disease, at the same premium charged a 65-year-old, with a one-time enrollment window in 2026 — but the bill was not enacted, and Utah Code §31A-22-620 still reads as last amended in 2025. As of April 2026, 40,601 Utahns on Medicare were under 65 (CMS). Some companies choose to offer under-65 policies voluntarily, often at a higher premium; check with the Utah Insurance Department and your State Health Insurance Assistance Program.
What happens if I apply for a Medigap policy outside a protected window?
The company can medically underwrite the application. That means health questions, possible review of your prescription and claims history, and the right to decline you or charge a higher premium. Utah law also permits a limited preexisting-condition waiting period: under §31A-22-620(3)(b), a Medicare supplement policy may not exclude benefits for a loss incurred more than six months after coverage starts because of a preexisting condition, and it may not define a preexisting condition more restrictively than one for which medical advice was given or treatment was recommended or received within six months before coverage started. Separately, every Utah Medicare supplement policy carries a 30-day right to return it for a refund.
Sources
- Utah Code §31A-22-620, Medicare Supplement Insurance Minimum Standards Act (as last amended by Laws of Utah 2025, Chapter 376; effective May 7, 2025): le.utah.gov/xcode/Title31A/Chapter22/31A-22-S620.html
- H.B. 258, Medicare Supplement Insurance Amendments, 2025 General Session (enrolled copy): le.utah.gov (H.B. 258 enrolled)
- H.B. 340, Medicare Supplement Amendments, 2026 General Session (introduced; not enacted): le.utah.gov (H.B. 340 introduced) · bill page
- Medicare.gov — When can I buy a Medigap policy? medicare.gov/health-drug-plans/medigap/ready-to-buy/when
- Medicare.gov — Can I switch or drop my Medigap policy? medicare.gov (switch or drop)
- Medicare.gov — Compare Medigap plan benefits (2026 out-of-pocket limits, high-deductible amount, Plan C/F availability): medicare.gov (compare plan benefits)
- CMS — Medicare Monthly Enrollment (Utah, April 2026): data.cms.gov (Medicare Monthly Enrollment)
- CMS — 2026 Medicare Parts A & B premiums and deductibles fact sheet: cms.gov (2026 Parts A & B fact sheet)
- Utah Insurance Department — Medicare / Medigap / Medicare Advantage consumer information: insurance.utah.gov/consumers/health-insurance/medicare
- Utah State Health Insurance Assistance Program (SHIP) — free Medicare counseling statewide: shiphelp.org/ships/utah · Utah Division of Aging and Adult Services
About this article. Written by the Utah Retirement Income Data Desk and reviewed by Brian Penner, Retirement income & long-term care planner. Educational only — not medical, financial, tax, or legal advice, and not a recommendation of any specific plan, provider, or product. Nothing here is a determination of your eligibility for any policy: only the insurance company can approve or decline an application, and only the Utah Insurance Department and the federal Medicare program can interpret the rules that govern them. Statutes, guaranteed issue rules, plan availability, and premiums change. Utah Retirement Income is a licensed independent insurance agency (NPN 16493717). We do not offer every plan available in your area; any information we provide is limited to the plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program to get information on all of your options. A plan with a $0 monthly plan premium is not free coverage — you continue to pay your Medicare Part B premium along with the plan's copayments, coinsurance, and deductibles. Insurance and annuity guarantees are subject to the claims-paying ability of the issuing company; there are no guaranteed investment returns and no guaranteed savings. Cost figures are for 2026 and change. We are not connected with or endorsed by any government agency, the federal Medicare program, the U.S. Department of Health and Human Services, the Utah Insurance Department, or Utah DHHS.