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Switching from Medicare Advantage to a Medicare Supplement (Medigap)

Switching from Medicare Advantage to Medicare Supplement (Medigap) coverage is possible if you meet specific requirements. If you are enrolled in a Medicare Advantage plan and are unhappy with your coverage, you can enroll in new coverage during the right enrollment periods.

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To switch from a Medicare Advantage plan to Medigap, you will likely need to answer underwriting health questions. Since Medicare Advantage and Medicare Supplement plans are so different, it is essential to understand which plan type works best for you before making the switch.

How to Switch from Medicare Advantage to Medicare Supplement?

There are a few different ways to go about making the switch from Medicare Advantage to Medicare Supplement plan, most of which involve the medical underwriting process. This means you must answer health questions to enroll in a Medigap plan. However, there are certain situations in which you can switch from Medicare Advantage to Medigap without having to answer underwriting health questions.

Step 1: Determine Eligibility

Before you decide to switch from a Medicare Advantage plan to a Medicare Supplement plan, you must first be eligible to leave your Medicare Advantage plan and qualify for a Medicare Supplement plan. This can only be done during specific enrollment periods. If you qualify for a Special Enrollment Period to return to Original Medicare, you may be able to use guaranteed issue rights to enroll in a Medicare Supplement plan

For example, if you were previously on a Medicare Supplement plan and switched to a Medicare Advantage plan for the first time, you are eligible to switch back to a Medicare Supplement within the first year of being on a Medicare Advantage plan without answering underwriting health questions.

However, outside of Special Enrollment Periods, you must be within a valid enrollment period, such as the Annual Enrollment Period to leave your Medicare Advantage plan and enroll in a Medicare Supplement plan by answering underwriting health questions.

Step 2: Research Medicare Supplement Plans and Carriers

Once you have determined your eligibility, it is essential to carefully research the Medicare Supplement plans and carriers available in your area. While Medigap plans are standardized, it is still important to do your research to determine which plan fits your needs best.

Once you know which plan to enroll it, finding the right carrier is just as important. Carriers determine your monthly premium, so finding a low-cost plan with great customer service is essential.

Step 3: Apply for Medicare Supplement Coverage

Before leaving your Medicare Advantage plan, you will need to apply for coverage through the Medicare Supplement carrier you wish to enroll with. You’ll want to do this before leaving your Medicare Advantage plan to ensure you are approved for coverage and not stranded without insurance if you are denied during underwriting.

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Step 4: Disenroll From Your Medicare Advantage Plan

Once you are approved for coverage, you must drop your Medicare Advantage plan before your Medicare Supplement coverage is active. Remember, you can only have active coverage from either a Medicare Supplement plan or a Medicare Advantage plan at one time.

When Can I Switch from Medicare Advantage to Medigap?

Throughout the year, certain enrollment periods allow you to disenroll from a Medicare Advantage plan and enroll in a Medicare Supplement plan if you pass medical underwriting. These include the Annual Enrollment Period and the Medicare Advantage Open Enrollment Period.

Each fall, the Annual Enrollment Period allows beneficiaries to leave their Medicare Advantage plan and return to Original Medicare. During this time, you can also apply for a Medicare Supplement plan. If you pass underwriting, you will enroll in the Medicare Supplement plan on January 1 of the following year.

From January 1 through March 31 each year, the Medicare Advantage Open Enrollment Period allows beneficiaries to make a one-time change to their Medicare Advantage plan. This includes disenrolling and enrolling in a Medicare Supplement plan.

Keep in mind neither of these scenarios allows you to enroll in a Medicare Supplement plan without answering Medicare Supplement underwriting questions. This means a carrier can deny you based on pre-existing health conditions. Thus, the importance of not disenrolling from your Medicare Advantage plan until you have been approved for your Medicare Supplement plan.

Pros of Switching from Medicare Advantage to Medicare Supplement

Medicare Supplement plans offer several advantages when compared to Medicare Advantage plans. So, depending on your needs, a Medicare Supplement plan might be the best coverage option.

Medicare Supplement plans offer fewer provider limitations. When you enroll in a Medicare Supplement plan, you are eligible to see any doctor or hospital nationwide. As long as the doctor accepts Original Medicare, your costs are the same. On the other hand, many Medicare Advantage plans force you to adhere to a small, restricted network of doctors and hospitals.

Most Medicare Supplement plans offer emergency coverage if you are traveling internationally. You can receive up to $50,000 of international emergency coverage through a Medicare Supplement plan. Medicare Advantage plans do not offer this benefit.

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Lastly, Medicare Supplement plans have fewer out-of-pocket expenses than Medicare Advantage plans. On most Medicare Supplement plans, once you meet the Medicare Part B deductible, you will not have to pay any additional out-of-pocket costs. On Medicare Advantage plans, you are often responsible for higher out-of-pocket maximums.

Cons of Switching from Medicare Advantage to Medicare Supplement

Although in many cases, Medicare Supplement plans reign superior to Medicare Advantage plans, this is not always the case. There are situations in which a Medicare Advantage plan outshines a Medicare Supplement.

Medicare Advantage plans provide additional benefits to Original Medicare that are not available with Medicare Supplement plans. Additionally, Medicare Advantage plans also offer lower monthly premium than most Medigap plans. However, with a low premium may come higher out-of-pocket costs. Anytime you enroll in a Medicare Supplement plan, you will pay an additional premium.

Lastly, to make the switch from Medicare Advantage to Medicare Supplement, you must undergo medical underwriting. This means a switch from a Medicare Advantage to a Medicare Supplement plan is not always a guarantee. There are many cases where individuals wish to switch plans but do not qualify based on health.

Can You Switch from Medicare Advantage to Medigap Without Underwriting?

The only time you may switch from a Medicare Advantage to Medigap without underwriting is if you have a Special Enrollment Period that grants you guaranteed issue rights. This means that you will be able to enroll in the plan of your choice with no health questions. Thus, you cannot be denied coverage for any reason.

Some of the most common Special Enrollment Periods to switch from Medicare Advantage to Medigap without underwriting health questions are called trial rights.

  • Trial Right 1: You join a Medicare Advantage Plan when you first become eligible for Medicare at age 65 and wish to switch to Medicare Supplement within the first year.
  • Trial Right 2: You disenrolled from a Medigap policy to enroll in a Medicare Advantage plan for the first time, and within the first 12 months of being on the Medicare Advantage plan, you wish to switch back to your original Medigap plan.

These two trial right situations are commonly overlooked by Medicare enrollees because they are unaware the rules exist. If you wish to switch from a Medicare Advantage plan to a Medicare Supplement plan, working with a knowledgeable licensed agent is the best way to ensure you do not miss out on enrollment opportunities such as trial rights.

Get Help with Switching from Medicare Advantage to Medigap

If you wish to switch from a Medicare Advantage to a Medicare Supplement plan, we have your back. At MedicareFAQ, we work with the top Medicare Supplement carriers nationwide to bring you the best coverage possible. To get started with your no obligation, free plan evaluation today, call the number above or complete our online rate comparison form.

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Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. Medigap, CMS. Accessed March 2022.
    https://www.cms.gov/medicare/health-drug-plans/medigap
  2. Medicare Advantage Plans, Medicare. Accessed March 2022.
    https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options
  3. A Chance to Switch or Ditch Your Medicare Advantage Plan, CNBC. Accessed March 2022.
    https://www.cnbc.com/2022/03/10/a-chance-to-switch-or-ditch-your-medicare-advantage-plan-ends-soon.html
Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare guru serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

8 thoughts on "Switching from Medicare Advantage to a Medicare Supplement (Medigap)"

  1. Great information! Quick question about “Trial Right 1: You join a Medicare Advantage Plan when you first become eligible for Medicare at age 65 and wish to switch to Medicare Supplement within the first year.” described above. This seems to be rarely noted. Can you point me to your source? Also, is the “first year” mean the year from 65 – 66 or a year from when you enroll if that happens to be ? months past one’s 65th? Thanks!

  2. To clarify, if after a couple of years in Medicare Advantage you decide to switch to original Medicare at open enrollment will there be medical underwriting?

    1. Hi Terry! There is no medical underwriting when switching back to Original Medicare from a Medicare Advantage plan during the Fall Open Enrollment period. However, you will have to answer medical underwriting questions if you would like to enroll in a Medicare Supplement plan alongside switching back to Original Medicare.

  3. Can you switch to Medicare Advantage from a Medicare Supplement (Medigap) plan and then switch back to a Medicare Supplement plan?

    If so, few questions:
    Can the switch from Medigap to Advantage be done anytime or just at Open Enrollment Oct 15?

    Is medical underwriting required?

    Can you pick any Insurance company, if your previous Insurance company is closed to new business?

    What do you do with your Part D drug plan when you switch to a Advantage plan with drug coverage? Thanks

    1. Hi Paul, great questions! Under the right circumstances, you can switch to Medicare Advantage from a Medigap, and vice versa as many times as you wish throughout your lifetime. However, enrolling in a Medigap plan may require medical underwriting after your initial enrollment.

      To switch from Medigap to Medicare Advantage you must be within the Annual Enrollment Period or have a Special Enrollment Period (such as moving). Medical underwriting is never required to enroll/switch to a Medicare Advantage plan. When enrolling during the Annual Enrollment Period you can choose any plan/company available in your area. When switching to a Medicare Advantage plan with drug coverage you must disenroll from your Medicare Part D plan as you can not have both coverages at the same time. Now, if you decide to switch back to a Medicare Supplement plan, you may be required to go through medical underwriting.

  4. well written newsletter. the areas covered give a simple easy to understand explanation of the the different processes regarding medications and especially changing from the medicare advantage program to original medicare.

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