Switching from a Medicare Advantage plan to a Medicare Supplement (Medigap) plan is one of the most common coverage changes Medicare beneficiaries consider -- and one of the most misunderstood. The process involves two separate steps: first, disenrolling from your Medicare Advantage plan during an eligible enrollment window; and second, applying for and being approved for a Medigap policy. The second step is where most people encounter obstacles.
Underwriting Is the Key Obstacle
In most states, Medigap insurers can use medical underwriting when you apply outside of a guaranteed issue window. This means they can charge you higher premiums, exclude pre-existing conditions, or deny your application entirely based on your health history. This is the single most important factor to understand before attempting to switch.
Can You Switch from Medicare Advantage to Medigap?
Yes, you can switch. However, the ability to get a Medigap plan depends heavily on when you try to switch and what state you live in. If you are within a guaranteed issue window, any insurance company selling Medigap in your state must accept your application at standard rates. Outside of a guaranteed issue window, most states allow insurers to underwrite your application.
Guaranteed Issue Windows: When You Can Switch Without Underwriting
A guaranteed issue right means an insurer must sell you a Medigap policy at standard rates, regardless of your health. The following situations give you guaranteed issue rights:
| Situation | Guaranteed Issue Right | Time Window |
|---|---|---|
Initial Medigap Open Enrollment Period | Any Medigap plan sold in your state | 6 months starting when you are 65+ and enrolled in Part B |
Medicare Advantage plan leaves your service area or loses its Medicare contract | Plans A, B, C, F, K, or L (if available) | 63 days after coverage ends |
You move out of your Medicare Advantage plan's service area | Plans A, B, C, F, K, or L (if available) | 63 days after coverage ends |
You joined Medicare Advantage when you first became eligible and want to switch back within 12 months | Any Medigap plan sold in your state | Within 12 months of joining Medicare Advantage |
You enrolled in a Medicare SELECT plan and want to switch to a standard Medigap plan | Plans A, B, C, F, K, or L (if available) | 63 days after coverage ends |
Plans C and F are only available to beneficiaries who became eligible for Medicare before January 1, 2020. Guaranteed issue rights vary by state -- some states offer additional protections.
The 12-Month Trial Right
If you joined a Medicare Advantage plan for the first time when you became eligible for Medicare, you have a 12-month trial period. If you switch back to Original Medicare within those 12 months, you have a guaranteed issue right to buy any Medigap plan sold in your state -- even if you have health conditions.
Switching Outside a Guaranteed Issue Window: What to Expect
If you do not have a guaranteed issue right, you will need to apply for Medigap through the standard underwriting process in most states. This means the insurer will review your medical history and may:
Approve your application at standard rates
Approve your application with a higher premium (rated up)
Approve your application with a waiting period for pre-existing conditions
Deny your application entirely
Common conditions that can lead to denial or higher rates include heart disease, diabetes with complications, COPD, cancer (within the past few years), kidney disease, and stroke history. The specific underwriting criteria vary by insurer, so it is worth applying to multiple companies. Learn more about how Medigap underwriting works.
State Protections: Birthday Rules and Additional Rights
Several states have enacted laws that give beneficiaries additional opportunities to switch Medigap plans without underwriting. The most common is the birthday rule, which allows you to switch to an equal or lesser Medigap plan during a window around your birthday each year -- without answering health questions.
| State | Protections Available |
|---|---|
California | Birthday rule: switch to equal or lesser plan within 60 days of birthday each year |
Illinois | Birthday rule: switch to equal or lesser plan within 45 days of birthday each year |
Louisiana | Birthday rule: switch to equal or lesser plan within 30 days of birthday each year |
Maryland | Birthday rule: switch to equal or lesser plan within 30 days of birthday each year |
Oklahoma | Birthday rule: switch to equal or lesser plan within 60 days of birthday each year |
Oregon | Birthday rule: switch to equal or lesser plan within 31 days of birthday each year |
Missouri, Nevada, Idaho, and others | Continuous open enrollment or additional guaranteed issue rights -- check your state's insurance department for current rules |
State rules change frequently. Always verify current protections with your state insurance commissioner or a licensed Medicare agent.
Note that birthday rules typically only allow you to switch between Medigap plans -- not to get a brand-new Medigap policy if you do not already have one. If you are coming from Medicare Advantage and have never had a Medigap plan, birthday rules generally do not apply to you. Learn more about guaranteed issue rights.
Step-by-Step: How to Switch from Medicare Advantage to Medigap
Check your enrollment window. Confirm you are within the Medicare Advantage Open Enrollment Period (January 1 to March 31), the Annual Enrollment Period (October 15 to December 7), or a qualifying Special Enrollment Period.
Apply for a Medigap plan first. Before disenrolling from Medicare Advantage, submit your Medigap application and get approved. This ensures you have coverage lined up before you leave your current plan.
Choose your Medigap plan. Plan G is the most comprehensive plan available to new Medicare enrollees in 2026. Plan N is a lower-premium alternative with some cost-sharing. Compare options based on your health needs and budget.
Disenroll from Medicare Advantage. Once your Medigap approval is confirmed, contact your Medicare Advantage plan or call 1-800-MEDICARE to disenroll. Alternatively, enrolling in a standalone Part D plan will automatically trigger disenrollment from your Medicare Advantage plan.
Enroll in a standalone Part D plan. Medigap plans do not include prescription drug coverage. You will need to add a Part D plan to maintain drug coverage.
Confirm your coverage start dates. Make sure there is no gap between when your Medicare Advantage coverage ends and when your Medigap and Part D coverage begins.
Apply for Medigap Before Disenrolling
Always get your Medigap application approved before you disenroll from Medicare Advantage. If your Medigap application is denied and you have already left Medicare Advantage, you could be left with only Original Medicare and no supplemental coverage.
Medicare Advantage vs. Medicare Supplement: Key Differences
| Feature | Medicare Advantage | Medicare Supplement (Medigap) |
|---|---|---|
Network restrictions | Usually required (HMO or PPO network) | None -- see any Medicare-accepting provider nationwide |
Out-of-pocket maximum | Yes (up to $9,250 in 2026) | Varies by plan; Plan G covers nearly all costs after Part B deductible |
Prescription drug coverage | Usually included (MAPD) | Not included -- requires a separate Part D plan |
Extra benefits | Often includes dental, vision, hearing, fitness | No extra benefits |
Premium | Often $0 or low monthly premium | Higher monthly premium, but lower out-of-pocket costs when you use care |
Referrals required | Often required for HMO plans | No referrals needed |
Best for | Healthy beneficiaries who want low premiums and extra benefits | Beneficiaries who want predictable costs and freedom to see any provider |
Medicare Advantage MOOP limit of $9,250 applies to in-network costs for 2026.
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