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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 Do I 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.

If you qualify for a Special Enrollment Period to return to Original Medicare, you may 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, 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 to leave your Medicare Advantage plan and enroll in a Medicare Supplement plan.

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 underwriting health 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.

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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.

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. Often, these benefits include coverage for dental, vision, hearing, and prescription drug coverage. Additionally, some plans go as far as providing free gym memberships, Medicare Part B premium reduction, transportation to and from appointments, and more. These benefits are not available with Medicare Supplement plans.

Medicare Advantage plans also offer low to no monthly premiums. Several Medicare Advantage plans have a $0 monthly premium, making them fit anyone’s month-to-month budget. However, with a low premium comes 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.

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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.

How to 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 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-Plans/Medigap
  2. Medicare Advantage Plans, Medicare. Accessed March 2022.
    https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans
  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

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

4 thoughts on “Switching from Medicare Advantage to a Medicare Supplement (Medigap)

  1. 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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