Medigap policyholders in Virginia and West Virginia can now switch to a new supplement policy without answering health questions, and New Mexico adds the same protection on January 1, 2027. The three laws are not copies of each other. Each sets its own window, its own limits on which insurer a person can move to, and its own rules on how much coverage can change.
What is a Medigap birthday rule?
Medigap is private insurance that fills gaps left by Original Medicare, the government plan made up of Part A and Part B. Medicare.gov says a person generally must have Original Medicare to buy a policy. Medicare Advantage and Part D drug plans are not covered by these state laws, AARP says.
Ordinarily, a policyholder who wants a cheaper plan can run into medical underwriting. That means the new insurer can look at health history and refuse the application or charge more. A birthday rule gives policyholders a yearly window in which that review is off the table.
For anyone paying a Medigap premium in one of the three states, the question is whether a cheaper policy can be had without a health review. In Virginia and West Virginia the answer is yes, inside a window tied to the policyholder’s birthday. In New Mexico the answer becomes yes on January 1, 2027.
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How Virginia’s window works
Virginia’s law took effect in July 2025, according to AARP’s Virginia guide. Every year a 60-day window opens on the policyholder’s birthday. During it, a person can apply for a policy with the same benefits from any insurer selling Medigap in the state.
In that window, insurers may not deny coverage, use medical underwriting or charge more because of health status, medical condition or claims history. Current insurers must send written notice 15 to 30 days before the window opens, spelling out the dates and the policyholder’s rights.
AARP writer Sheila Burke points to a 76-year-old Virginian, Deborah Myers, who moved from one Plan G policy to another. Her premium fell from $325.79 to $137.66 a month. That is about $188 a month, or more than $2,200 a year, for the same plan letter.
The phrase “same benefits” is the catch. A Plan G holder can move to another Plan G. A move to a different plan letter is not guaranteed under the birthday rule and can still involve underwriting, AARP says.
West Virginia keeps switchers close to home
West Virginia’s House Bill 4869 passed the Senate on March 13, 2026, and the governor approved it on March 27, according to the state legislature’s bill history. It became Chapter 185 of the 2026 Acts and took effect ninety days from passage, on June 11, 2026.
Becker’s Payer Issues reports that the state sets a 60-day window each year around the birthday. Two conditions narrow it. A policyholder must have held the policy continuously for at least 24 months, measured to the date the new coverage starts.
The second limit is the insurer. West Virginia beneficiaries can only switch to a plan from the same or an affiliated insurer, Becker’s reports, unless comparable coverage is unavailable. Virginia lets a policyholder shop every insurer in the state. West Virginia effectively limits the shopping to one company family.
Becker’s also notes a separate guaranteed-issue right in West Virginia for people who lose Medicaid eligibility. That is a different trigger from the birthday window, and it does not depend on the 24-month rule.
New Mexico’s rule starts January 1, 2027
New Mexico’s Senate Bill 21, titled “Medicare Supplement Open Enrollment,” was signed by the governor on March 3, 2026, and became Chapter 10 on the legislature’s final text. That text sets its effective date as January 1, 2027.
New Mexico’s window works differently. It starts on the first day of the policyholder’s birthday month and stays open for at least 60 days. In Virginia and West Virginia the window starts on the birthday itself.
The bill lets a policyholder buy any policy an insurer offers in the state with “an equal or lesser value” than the current one. Issuers may not deny, delay or condition coverage over health status, claims or medical condition. The new policy also cannot exclude pre-existing conditions that the old one covered.
That makes New Mexico looser than Virginia on one point. A policyholder there can step down to less coverage as well as move sideways, and can choose among insurers. Becker’s reports that the state’s Aging Services department said SB 21 “would help level the playing field,” and that the law is expected to support more than 70,000 people.
Does the window reach beyond these three states?
AARP counts 16 states with this kind of law, Virginia included, and notes that New Mexico’s does not take effect until 2027. The details differ from state to state, as the three above show. Window length, start date, insurer limits and waiting periods all vary.
The windows also repeat only once a year. A policyholder who misses the 60 days in Virginia or West Virginia waits for the next birthday. In New Mexico, the window opens at the start of the birthday month, so the calendar is slightly different.
Living outside Virginia, West Virginia and New Mexico?
A birthday window is a state-by-state right. Policyholders in states without one cannot count on switching for a lower premium, and the cost of a Medigap plan keeps coming out of the same monthly check.
The Medicare Cost & Coverage Protection Kit includes 51 state Medicare cost-help packs, covering the programs that help pay Medicare premiums and drug costs where the limits and applications differ by state.
Each pack lays out that state’s programs in one place, so a household can see which routes exist locally before the next premium notice arrives.
Get the 51 state Medicare cost-help packs in one kit →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
