Effective May 7, 2025, the State of Utah has enacted new changes to its Medicare Supplement Insurance policies. These amendments are designed to improve flexibility and access for Medicare beneficiaries seeking to adjust their Medigap coverage without being penalized for health conditions. Here’s everything you need to know about the new legislation and how it may affect your Medicare Supplement options in Utah.
Key Highlights of the 2025 Medicare Supplement Law Changes in Utah
The 2025 General Session of the Utah Legislature passed a bill amending Section 31A-22-620, also known as the Medicare Supplement Insurance Minimum Standards Act. Here are the most important updates:
1. Plan Switching Made Easier for Enrollees
The new law allows Medicare Supplement policyholders to:
Switch to a comparable or lower-tier plan offered by the same insurance company.
Make this change once per year, during a special window starting on their birthday and lasting for 60 days.
2. No Medical Underwriting Required
Insurance companies can no longer deny coverage or impose higher premiums based on health conditions if a beneficiary chooses to:
Switch from their current Medigap plan to a comparable or lower-tier plan offered by the same insurer during the designated period.
3. Consumer Protections and Standardization
The law continues to enforce:
Prohibition of duplicate benefits already provided by Medicare.
Protection from denial due to pre-existing conditions after six months of coverage.
Requirements for clear and standardized outlines of coverage and policy disclosures.
Oversight by the Utah Insurance Commissioner, who has the authority to adopt rules to ensure fairness, transparency, and compliance with federal guidelines.
What This Means for Medicare Beneficiaries in Utah
If you’re enrolled in a Medicare Supplement plan in Utah, these changes give you greater control over your coverage. You can now:
Downgrade to a less expensive plan without fear of being denied due to health issues.
Make better-informed choices with improved transparency from insurers.
Take advantage of a “Birthday Rule” that mirrors similar provisions in other states like California and Oregon.
Why This Change Matters
Historically, Medicare Supplement plans required medical underwriting when switching between plans, especially outside of the initial enrollment period. This meant that people with chronic conditions or recent diagnoses often faced denial or higher premiums if they wanted to change plans.
The new Utah law removes this barrier—for comparable or lower-tier switches within the same company—giving seniors more flexibility to adjust coverage as their health needs and financial situations evolve.
What Is a “Comparable or Lower-Tier” Plan?
A comparable or lower-tier plan refers to a Medigap plan that:
Offers similar or fewer benefits than your current plan.
Is considered to be at the same level or lower in terms of coverage (e.g., switching from Plan G to Plan N).
Insurers are responsible for defining what qualifies as “comparable,” but the law mandates that coverage cannot be denied based on medical conditions when switching between these plans.
When Does This Take Effect?
The law goes into effect on May 7, 2025. If your birthday is on or after that date, you’ll be eligible for this new switching window during your birthday month each year.
Frequently Asked Questions (FAQs)
Can I switch to a different insurance company under this law?
No. The 2025 law only allows you to switch to another Medigap plan offered by the same insurance company without medical underwriting.
Does this affect Medicare Advantage plans?
No. These changes apply only to Medicare Supplement Insurance (Medigap) policies, not to Medicare Advantage plans.
Do I have to wait until my birthday to make changes?
Yes. The birthday rule provides a 60-day window starting on your birthday each year during which you can switch plans under these protections.
Final Thoughts: How to Prepare
To make the most of Utah’s 2025 Medicare Supplement Insurance changes, review your current Medigap coverage, compare available comparable or lower-tier plans from your insurer, and mark your birthday each year as the start of your 60-day switching window. If you’re unsure how these changes affect you, consult a licensed Medicare advisor who understands Utah’s updated Medigap rules to help you choose the best plan for your needs.
To learn more about Utah Medicare Supplement Insurance Amendments, please contact one of our trusted representatives directly at 1-888-559-0103.
