Florida Medigap Rules: Open Enrollment, Guaranteed Issue and Why There's No Birthday Rule

Florida has no Medigap birthday rule. Nothing in the Medicare supplement part of the Florida Statutes (ss. 627.671-627.675) or in the state's Medigap rules (chapter 69O-156) gives you a yearly chance to switch Medicare Supplement policies without health questions. That makes your first six months on Part B the window that matters most.

Federal law sets the baseline: a one-time, six-month Medigap Open Enrollment Period and a short list of guaranteed-issue situations. Florida adds three things on top. People under 65 who have Medicare because of a disability or end-stage renal disease (ESRD) get their own six-month window. Losing group health coverage opens a two-month window. And companies can't price Medigap policies so that your premium climbs just because you got a year older.

Source: CMS, Choosing a Medigap Policy, 2026; s. 627.6741, Fla. Stat.; s. 627.674(4)(d), Fla. Stat..

The six months that decide most of it

Your Medigap Open Enrollment Period starts the first month you have Part B and are 65 or older, and it runs six months. CMS is blunt that it's a one-time period that doesn't repeat (CMS guide). During it, a company can't refuse to sell you any Medigap policy it offers, can't use medical underwriting and can't charge you more because of health problems.

Florida writes the same protection into state law. Section 627.6741(1)(a)1 requires every company selling Medicare supplement policies here to accept Florida residents during the six-month period that begins with the first month they're 65 and enrolled in Part B, without conditioning the policy on health status or pricing it differently. Rule 69O-156.009 adds that every policy a company currently offers must be available to anyone who qualifies, "without regard to age."

Here's a labelled example of how the dates stack up.

Source: Medicare.gov, When does Medicare coverage start?; CMS, Choosing a Medigap Policy, 2026; s. 627.6741(1) and s. 627.674(4)(d), Fla. Stat. Example dates are illustrative.

Two timing traps. If your birthday falls on the 1st, Florida's Department of Financial Services notes that Part B and Medigap open enrollment begin the first day of the previous month (DFS). And the window follows Part B, not your birthday: if you delay Part B because of coverage from your or your spouse's current job, as CMS says you may, the Medigap window starts later too.

After the six months, CMS warns, you may pay more, have fewer choices, or be turned down by a company that uses medical underwriting.

No birthday rule: what switching looks like in Florida

Florida law doesn't give Medigap policyholders a yearly window, around a birthday or otherwise, to change policies without health questions. I checked the 2026 Florida Statutes, rule chapter 69O-156, and the Florida Senate's bill search for the 2025 and 2026 regular sessions. The search found no 2026 bill mentioning "Medicare supplement," and the only 2025 one was SB 1428 (2025), a broader consumer-protection bill that died in committee on June 16, 2025. Section 627.6741 itself was last amended in 2016.

So in Florida, switching follows the federal rule. CMS says that in most cases you won't have a right to switch Medigap policies unless you're still in your six-month open enrollment period or you're in a guaranteed-issue situation. Outside those, you can apply for any policy you like, but the company can ask health questions and say no.

If you do switch, do it in this order:

• Don't cancel the old policy first. CMS says keep it until you've decided to keep the new one (you'll pay both premiums that month).
• Use the 30-day free look. Florida requires every Medigap policy to let you return it within 30 days after you receive it for a full refund of any premium paid (s. 627.674(4)(d)).
• Expect a new age. Per DFS, a new insurer rates you on your age at the new application.
• Your waiting-period credit carries over. If the new policy replaces another Medigap policy or creditable coverage, the new company must credit the time you already served toward any pre-existing condition or waiting period for similar benefits (s. 627.6741(2)(c)).

Guaranteed-issue rights and Florida's 2-month window

Guaranteed-issue rights let you buy certain Medigap policies outside open enrollment when other coverage changes. In those situations, CMS says the company must sell you a policy, must cover your pre-existing conditions and can't charge more because of your health. Florida's version, Rule 69O-156.0095, mirrors the federal list.

Source: CMS, Choosing a Medigap Policy, 2026, pp. 17-18. *C and F aren't available to people new to Medicare on or after January 1, 2020; they can buy D or G instead. Florida rule: F.A.C. 69O-156.0095.

Florida's extra window. Section 627.6741(1)(a)2 adds a state right: a Florida resident who is 65 or older (or under 65 on Medicare by disability or ESRD) and enrolled in Part B can enroll in a Medicare supplement policy, without health-based conditions or pricing, "during the 2-month period following termination of coverage under a group health insurance policy." DFS describes it as the 2 months after employer-based group coverage ends. Don't read that as more time to sit on a decision. The federal deadline for the same event is 63 days, so apply as soon as you have the termination letter.

Whatever the trigger, keep the letters, notices or claim denials that show your coverage ended, plus the postmarked envelope. CMS says you may have to send copies with the application.

The 12-month trial right

Two guaranteed-issue rights exist so people can try Medicare Advantage without losing their path back to Medigap:

• New to Medicare. If you joined a Medicare Advantage plan or PACE when you first became eligible for Part A at 65, and you decide within the first year to switch to Original Medicare, you can buy any Medigap policy sold in your state. Florida's rule says the same: "any Medicare supplement policy offered by any issuer."
• You dropped Medigap. If you dropped a Medigap policy to join Medicare Advantage (or a Medicare SELECT policy) for the first time and you've been in it less than a year, you can get your old policy back if the same company still sells it. If it doesn't, you can buy Plan A, B, C*, D*, F* or G*.

For both, CMS says to apply as early as 60 days before the coverage ends and no more than 63 days after.

The fall Medicare Open Enrollment Period (October 15 to December 7, 2026, for 2027 coverage) is for Medicare Advantage and Part D (Medicare.gov). It doesn't create any Medigap right on its own. If you plan to leave Medicare Advantage this fall, confirm whether one of these rights applies before you count on getting a Medigap policy.

Under 65 on Medicare in Florida

This is where Florida does more than federal law. Federal law generally doesn't require companies to sell Medigap to people under 65. Florida is on CMS's list of states that require at least one kind of Medigap for people under 65, and s. 627.6741(1)(a)1 gives Florida residents on Medicare by disability or ESRD the same six-month open enrollment period, starting once they're enrolled in Part B. The rule has applied since October 1, 2009.

DFS spells out what that means in practice (DFS overview):

• All companies that sell Medicare Supplement policies in Florida must offer their policies to people under 65.
• Rates for people on Medicare because of disability or ESRD are higher than for people eligible by age.
• At 65 you get another open enrollment period. To get the lower age-65 rate, you have to apply for a new policy.

That last point is the one people miss. If you're on Medigap because of a disability, mark the month you turn 65 on your calendar.

Source: CMS Medicare Monthly Enrollment, Florida, June 2026. The A-and-B figure is the group that can generally buy Medigap, not a count of Medigap policyholders.

Issue-age pricing and rate increases

CMS describes three ways companies can price Medigap: community-rated (generally the same for everyone regardless of age), issue-age (based on your age when you buy) and attained-age (based on your current age, so it rises as you get older).

Florida takes attained-age off the table. Section 627.410(6)(d)3 prohibits "attained age premium structures on policy forms under which more than 50 percent of the policies are issued to persons age 65 or over." Medigap forms are generally sold mostly to people 65 and over, and DFS states it directly: "All Florida Medicare Supplement policies must be sold on an 'issue age basis.'" Its example: buy at 65 and you keep the rate of a 65-year-old.

That doesn't freeze your premium. Here's what can still move it, and the checks on each:

• Rate increases need approval. A company can't use or change Medigap rates until the Office of Insurance Regulation approves them (Rule 69O-156.012(2)). DFS adds that an increase has to apply to the whole policy class, not to one person because of health or claims.
• 45 days' notice. Per DFS, an approved rate change must be mailed to you at least 45 days in advance.
• Loss ratios. Individual policies must return at least 65% of earned premium as benefits over the life of the policy, and the state must have a written policy on public hearings before approving Medigap premium increases (s. 627.6745).

Within a policy form, rates may vary only by age, gender, area and tobacco use (69O-156.012(3)(d)).

The lettered plans and the 2026 numbers

Medigap policies are standardized. In Florida, as in most states, they're named by letter, and every policy with the same letter has the same basic benefits no matter who sells it. CMS says the premium is the only difference between policies with the same letter from different companies. Companies don't have to sell every letter, but all must offer Plan A.

Source: CMS, Choosing a Medigap Policy, 2026 (Product No. 02110) benefit chart; K and L limits from Medicare.gov, Compare Medigap plan benefits. *Plan N: copays of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to an inpatient admission.

Source: CMS, 2026 Medicare Parts A & B premiums and deductibles fact sheet (Nov. 14, 2025); Medicare.gov, Compare Medigap plan benefits.

What those rows mean in practice:

• C and F are closed to anyone new to Medicare on or after January 1, 2020. If you were eligible before then, you may still be able to buy them.
• K and L cap your spending. After you reach the $8,000 (K) or $4,000 (L) limit and the yearly Part B deductible, the policy pays 100% of covered services for the rest of the calendar year.
• High-deductible F and G. You pay up to $2,950 in Medicare-covered costs in 2026 before the policy pays anything.
• Not included anywhere: prescription drugs (Medigap plans sold after 2005 don't cover them; that's Part D), and Medigap can't be combined with Medicare Advantage. It can't pay Medicare Advantage copays, deductibles or premiums (Medicare.gov).

The 2027 figures aren't out yet. As of October 16, 2026, CMS hadn't published the 2027 Part A and Part B amounts; it announced the 2026 numbers on November 14, 2025.

For snowbirds: Medigap follows Original Medicare anywhere in the U.S. Medicare SELECT is the exception, since it uses a network in a service area Florida approves (69O-156.030). Letters C, D, F, G, M and N add a foreign travel emergency benefit: 80% after a $250 yearly deductible, up to $50,000 lifetime (Medicare.gov). More in Medicare for Florida snowbirds.

Florida vs. Washington

We work in both states, so here they are side by side. Washington's switching right comes from RCW 48.66.045 and works year-round; it isn't tied to a birthday.

Source: CMS guide 2026; Florida: s. 627.6741, s. 627.410(6)(d), s. 627.674, F.A.C. 69O-156.030, DFS; Washington: RCW 48.66.045, RCW 48.66.130, RCW 48.66.120, RCW 48.66.055, OIC handbook.

The Washington details are in Medicare Supplement in Washington State.

How many Floridians are in Original Medicare

Florida's 65-and-older population is the second largest in the country, behind only California: 5,346,788 people on July 1, 2025, or 22.8% of residents, against 18.9% nationally (Census Bureau, Vintage 2025 estimates).

Medigap only works with Original Medicare, and that's a shrinking share of Florida's Medicare population. In 2013, 64.0% of Florida beneficiaries were in Original Medicare. By 2025 it was 43.4%, and in June 2026 it was 42.9%: 2,287,617 people, with 3,046,820 (57.1%) in Medicare Advantage and other health plans.

• Original Medicare
• Medicare Advantage & other

1.0M1.5M2.0M2.5M3.0M3.5M

20132016201920222025

Source: CMS Medicare Monthly Enrollment (annual rows), Florida

Show the numbers

	Original Medicare	Medicare Advantage & other
2013	2.4M	1.4M
2014	2.4M	1.5M
2015	2.4M	1.6M
2016	2.5M	1.7M
2017	2.5M	1.8M
2018	2.5M	2.0M
2019	2.5M	2.1M
2020	2.4M	2.3M
2021	2.4M	2.4M
2022	2.3M	2.6M
2023	2.3M	2.7M
2024	2.3M	2.9M
2025	2.3M	3.0M

The lines crossed in 2021. That's a description, not a recommendation; the right fit depends on your doctors, travel, health and budget. It does mean many Floridians face the Medigap question later, outside their first six months, when health questions can apply. Know your guaranteed-issue rights before a move you can't easily undo.

Other Florida protections worth knowing

• Guaranteed renewable. A company can't cancel or nonrenew your Medigap policy for any reason other than nonpayment of premium or material misrepresentation (s. 627.6741(2)(a)).
• Pre-existing conditions. A new (non-replacement) policy can't exclude a pre-existing condition for more than 6 months, and the look-back is 6 months (s. 627.6741(2)(b)). During the open enrollment or group-termination windows, there's no exclusion at all if you had at least 6 months of continuous creditable coverage.
• Paperwork before you buy. You should get an outline of coverage when you apply, along with the Medicare Supplement buyer's guide (s. 627.674(4)(f)-(g)). Read the outline against what you have now.
• If you qualify for Medicaid. You can ask the company to suspend your Medigap benefits and premiums for up to 24 months while you're entitled to Medicaid. If you lose Medicaid and notify the company within 90 days, the policy is reinstated automatically (s. 627.6744(4)). If your income is limited, the Medicare Savings Programs may pay some Medicare costs; see Medicare Savings Programs in Florida.

Where to get unbiased help

SHINE (Serving Health Insurance Needs of Elders) is a free program of the Florida Department of Elder Affairs and the local Area Agencies on Aging. Its trained volunteers give one-on-one Medicare counseling that the program describes as free, unbiased and confidential. Call 1-800-96-ELDER (1-800-963-5337) or start at floridashine.org. TTY users can call 1-800-955-8770, the number listed in Medicare & You.

If a company turns you down when you believe you have a guaranteed-issue right, or you have a rate or claim problem, call the Florida Insurance Consumer Helpline at 1-877-693-5236 (DFS). Medicare itself is at 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

For an overview of how Medicare coverage types fit together here, see our Florida Medicare page, and the Florida Medicare Supplement page for where Medigap fits.

FAQ

Does Florida have a Medigap birthday rule?

No. Florida's Medicare supplement statutes (ss. 627.671-627.675) and rule chapter 69O-156 don't give a yearly or birthday-based right to switch Medigap policies without health questions. Outside your six-month open enrollment period or a guaranteed-issue situation, a company can use medical underwriting.

Can I get a Medicare Supplement in Florida if I'm under 65?

Yes. Florida residents on Medicare because of a disability or end-stage renal disease get a six-month open enrollment period once they're enrolled in Part B (s. 627.6741). Rates are higher than for people eligible by age, and at 65 you get another open enrollment period.

Do Medigap premiums go up with age in Florida?

Not because of age alone. Florida prohibits attained-age premium structures on Medigap forms, and the Department of Financial Services says Florida policies must be sold on an issue-age basis. Premiums can still rise for other reasons, and the Office of Insurance Regulation must approve any rate increase first.

Your own policy wording and Florida law control. Confirm your situation with a licensed agent, SHINE, the Florida Department of Financial Services or Office of Insurance Regulation, or, for legal questions, an attorney.

Sources

1. CMS, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, 2026 (Product No. 02110)
2. Medicare.gov: How Medigap works
3. Medicare.gov: Compare Medigap plan benefits (2026 K/L limits, high-deductible F/G)
4. Medicare.gov: When does Medicare coverage start?
5. Medicare.gov: Joining a plan (enrollment periods)
6. Medicare.gov: Medicare coverage outside the United States
7. CMS: 2026 Medicare Parts A & B premiums and deductibles fact sheet (Nov. 14, 2025)
8. CMS: Medicare Monthly Enrollment, Florida (June 2026 and annual rows)
9. U.S. Census Bureau: Vintage 2025 state population estimates by age (sc-est2025-alldata6)
10. Florida Statutes ch. 627 part VIII, Medicare supplement policies (2026)
11. Florida Statutes s. 627.6741: issuance, cancellation, nonrenewal and replacement (2026)
12. Florida Statutes s. 627.674: minimum standards; 30-day free look (2026)
13. Florida Statutes s. 627.6744: excessive insurance; Medicaid suspension (2026)
14. Florida Statutes s. 627.6745: loss ratio standards; public rate hearings (2026)
15. Florida Statutes s. 627.410: rating practices; attained-age prohibition (2026)
16. F.A.C. chapter 69O-156: Medicare Supplement Insurance
17. F.A.C. 69O-156.009: Open Enrollment
18. F.A.C. 69O-156.0095: Guaranteed Issue for Eligible Persons
19. F.A.C. 69O-156.012: Filing and approval of policies and premium rates
20. F.A.C. 69O-156.030: Medicare Select policies (incl. (13)(a) same-issuer switch)
21. Florida Senate: SB 1428 (2025)
22. Florida DFS: Medicare Supplement Insurance Overview
23. SHINE, Florida Department of Elder Affairs
24. Medicare.gov: Medicare & You handbook (SHIP directory, SHINE TTY)
25. RCW 48.66.045: Washington Medigap replacement right and community rating
26. RCW 48.66.130: Washington pre-existing condition limits
27. RCW 48.66.120: Washington 30-day return
28. RCW 48.66.055: Washington guaranteed-issue situations
29. WA OIC/SHIBA: What you need to know about Medigap plans