In 2025, Virginia implemented a transformative healthcare policy aimed at enhancing consumer protections and providing greater flexibility for Medicare recipients. The new law, documented under BillTrack50 , introduces an annual open enrollment period for Medicare supplement policyholders.

Known as the “birthday rule,” this legislation allows individuals to switch Medigap plans of same benefits within 60 days of their birthday without undergoing medical underwriting. This means Virginians can now shop for better pricing or more appropriate coverage without being penalized for their health status.

What Is the 2025 Virginia Birthday Rule?

The birthday rule is a state-mandated opportunity for Medicare beneficiaries to review and adjust their Medigap coverage each year. Starting in 2025, if you have a Medicare supplement policy in Virginia, you are entitled to a 60-day window beginning on your birthday to change to a different policy offering the same benefits. Insurers are prohibited from using health status or pre-existing conditions to deny coverage or set rates during this period.

Key Protections Under the New Law

This landmark policy enhances transparency and consumer rights in several ways:

• Guaranteed Issue Rights: During the 60-day window, insurers must accept your application regardless of your health.
• Notification Requirements: Insurance providers must notify policyholders at least 15 days before their birthday window opens, detailing their rights and plan options.
• No Medical Underwriting: You won’t be asked to complete a health questionnaire or face higher rates due to medical conditions.

These protections are modeled after similar rules in states like California and Oregon, which have successfully empowered seniors with greater choice and cost control.

Benefits for Virginia Medicare Supplement Policyholders

For the thousands of Virginians currently enrolled in Medicare supplement policies in Virginia, this new law brings several benefits:

• Pricing Flexibility: You can shop for more competitive premiums without risking loss of coverage.
• Plan Optimization: Adjust your plan to better match your current healthcare needs.
• Freedom of Choice: Increased opportunity to find the insurer and coverage that best suits your budget and medical usage.

Real-World Impact: An Example

Imagine you’re enrolled in Plan G but find a more affordable version of the same plan from a different insurer. Under the old rules, switching might have required you to pass medical underwriting. Under the 2025 birthday rule, you can now make the switch effortlessly during your 60-day birthday window saving money while keeping your coverage intact.

What Plans Are Eligible?

You may switch to any Medigap plan that offers the same  benefits as your current plan. You cannot switch to a plan with lesser benefits, such as moving from Plan G to Plan N or Plan K, during this window

This flexibility is designed to help Virginians control rising premiums while maintaining coverage.

Take Action: Prepare for Your Birthday Window

Now more than ever, staying informed about your rights and timing is crucial. Here’s how to make the most of the new law:

1. Mark your calendar: Know when your 60-day window starts.
2. Review your current coverage: Assess if it’s meeting your needs and budget.
3. Compare options: Use the Virginia Medigap Plan Search or work with a local advisor.
4. Act within the window: Contact your insurer or a trusted agent like Croft Insurance Services for help switching plans.

How Croft Insurance Services Can Help

At Croft Insurance Services, we specialize in guiding Virginia residents through the Medicare maze. Our licensed advisors can help you:

• Understand the birthday rule and how it applies to you
• Compare current Medigap plans available in your area
• Submit your application within the appropriate timeframe

Empower Your Medicare Decisions

Virginia’s new 2025 birthday rule for Medicare supplement policies in Virginia represents a major win for consumer choice and healthcare affordability. By offering an annual opportunity to reassess and improve coverage without penalty, the state is helping seniors stay protected, informed, and financially secure.

Contact Croft Insurance Services today to learn how this new law impacts you and take the next step toward better Medicare coverage.