Federal vs state Medigap protections

Continuous- or annual-GI states (CT, ME, MA, NY)

In these states, federal guaranteed-issue rights are extended either continuously (year-round) or annually beyond the federal 6-month floor. Specifically:

• Connecticut, Massachusetts, New York: continuous (year-round) guaranteed-issue with community rating. Premiums are the same regardless of age, health, or claims history.
• Maine: each insurer must designate a one-month annual guaranteed-issue window for Plan A. Other plan letters may still be subject to medical underwriting outside the federal 6-month OEP.

In these states, the federal 6-month OEP is structurally less load-bearing because the state floor is higher. See the state pages →

Birthday-rule states (CA, OR)

California and Oregon allow Medigap policyholders an annual underwriting-free switching window tied to the policyholder’s birthday. The mechanics differ slightly:

• California: 30-day window starting on the policyholder’s birthday. May switch to an equal-or-lesser Medigap plan. Per Cal. Ins. Code § 10192.12, insurers must give 60-day advance notice.
• Oregon: 30-day window starting on the policyholder’s birthday. May switch to a same-or-lesser Medigap plan. OAR 836-052-0143.

The federal 6-month OEP still applies as the primary entry window. The birthday rule is the secondary annual switch window for already-insured Medigap policyholders.

Structural-exception states (MA, MN, WI)

Massachusetts, Minnesota, and Wisconsin do not use the federal 10-letter Medigap plan system. Each operates a state-specific Medigap structure:

• Massachusetts: Core, Supplement 1, Supplement 1A. (Massachusetts is also a continuous-GI state.)
• Minnesota: Basic Plan + Extended Basic Plan + Minnesota versions of K, L, M, N. Optional state-defined riders.
• Wisconsin: Single basic Medigap plan + 50% / 25% Cost-sharing Plans + high-deductible plan + optional state riders.

The federal 6-month OEP guaranteed-issue rules still apply in these states — but the plan letters don’t. If you read about “Plan G” from a national source and you live in MA / MN / WI, that information doesn’t map to your state. See state pages →

Federal-floor states (the rest)

In the remaining 42 states (and DC), the federal 6-month Medigap OEP is your primary guaranteed-issue window. Outside that window, insurers may medically underwrite, deny, or surcharge in most cases — subject to the federal qualifying-event protections described in our 30-day-look-back guide.