Medigap if you're under 65: which states require it

People under 65 can get Medicare because of a disability, End-Stage Renal Disease (ESRD) or ALS. Federal law only requires Medigap insurers to sell to people 65 and older, so for everyone else, your state's rules decide whether you can buy a policy, and at what price.

States that require insurers to offer Medigap under 65

In states not listed, some insurers may still sell to people under 65 voluntarily, but they don't have to. Even in listed states, the plans offered and the price can be limited; premiums for people under 65 are often higher.

You get a second chance at 65

When you turn 65, you get your own 6-month Medigap Open Enrollment Period, even if you've had Medicare for years. During it, any insurer must sell you any Medigap policy it offers, at the same price as other 65-year-olds, without health questions. Several states also stop charging under-65 rates once you turn 65.

Other options

A Medicare Advantage plan is open to anyone with Medicare Parts A and B, including people under 65, and some states' Medicaid or Medicare Savings Programs can help with costs. Your SHIP can tell you what's available where you live.

Source: the NAIC state chart dated May 11, 2026. Confirm with your state insurance department.