Can I Switch From Medicare Advantage to Medigap?
Yes, most beneficiaries can switch from Medicare Advantage to a Medicare Supplement plan (Medigap), but only during these periods:
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AEP
- Medicare Annual Enrollment Period – October 15th through December 7th each year.
- *Medical underwriting may be required.
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OEP
- Medicare Advantage Open Enrollment Period – January 1st through March 3st each year.
- *Medical underwriting may be required.
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SEPs
- Special Enrollment Periods – if you lose coverage due to certain life events.
- Medical underwriting not required.
*Important to note: If you switch from Medicare Advantage to Medigap outside of a Special Enrollment Period, insurance providers may require medical underwriting to assess your medical history and current health. The insurer might deny you a plan or charge higher premiums depending on the risk.
Special Enrollment Periods
According to Medicare.gov, you can switch your Medicare Advantage coverage during Special Enrollment Periods (SEPs) triggered by specific life events.
Here are some scenarios that may qualify you for a SEP:
- Moving to an area not covered by your current plan
- Losing health insurance from your current employer
- Medicare discontinuing the plan’s contract
Additional situations may qualify you for an SEP, which is evaluated on a case-by-case basis.
How Do I Switch From Medicare Advantage to Medigap?
If you are eligible to switch from your Medicare Advantage plan to a Medicare Supplement plan, you can follow these steps:
#1. Apply for Medigap: Before leaving your Medicare Advantage plan, you must apply for coverage through the Medigap provider you wish to enroll with. Applying for coverage beforehand ensures that you are approved and not left without insurance if you are denied during underwriting.
#2. Disenroll from your Medicare Advantage plan: Once approved for a Medigap plan, you must drop your Medicare Advantage plan before the new Medigap coverage becomes active. You can also enroll in a standalone Part D plan to maintain prescription drug coverage.
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How Do I Disenroll?
You can contact your Medicare Advantage plan provider directly, or you can choose to enroll in a prescription drug plan, which will disenroll you from Medicare Advantage.
Can I Have Medicare Advantage and Medigap at the Same Time?
No, you can’t have active Medicare Advantage and Medigap plans simultaneously because they’re both based on Original Medicare.
Medicare Advantage replaces Original Medicare, while Medigap fills the coverage gaps.
Also, an insurance company can’t legally sell you a Medigap plan if they know you’re enrolled in an Advantage plan (unless you prove in writing that you’re switching).
The Medicare Advantage Trap: What They Don’t Tell You at 65
One of the biggest pitfalls I see new enrollees fall into is what I call the Medicare Advantage trap.
If you’re turning 65 and new to Medicare, you need to understand this next section before making a decision that could impact your healthcare for the rest of your life.
The Initial Open Enrollment Period: Your One-Time Opportunity
When you first become eligible for Medicare at 65, you have a six-month Medigap Open Enrollment Period. This window is critical because, during this time, you have guaranteed issue rights – meaning you can get a Medigap policy with no health questions asked. Insurers cannot deny you coverage or charge you more based on your health conditions.
Unfortunately, most people don’t even realize this window exists because they are bombarded with Medicare Advantage marketing from TV ads, mailers, and phone calls.
Medicare Advantage plans are often pitched as having low or even zero-dollar premiums and sound incredibly appealing. But those ads don’t tell you what happens if you’re unhappy later and want to switch to Medigap.
The Trap: Losing Your Guaranteed Issue Rights
Many new Medicare enrollees jump into a Medicare Advantage plan without realizing that once their six-month Medigap Open Enrollment Period ends, their ability to get a Medigap plan later is no longer guaranteed.
If you’re in a Medicare Advantage plan for a year or two and decide you don’t like it – maybe you’re struggling with network restrictions, high out-of-pocket costs, or denied coverage for certain procedures – you might think you can switch to Original Medicare and pick up a Medigap plan.
But here’s the catch: Medigap insurers will now require medical underwriting.
This means they can:
- Deny you coverage if you have pre-existing health conditions or
- Charge you significantly higher premiums.
This is the devastating reality that no one warns you about. Once you’ve lost your guaranteed issue rights, getting into a Medigap plan later can be difficult – or even impossible – depending on your health.
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Why Don’t Agents Say This?
The hard truth is that most insurance agents don’t bring this up because Medicare Advantage plans pay them much higher commissions than Medigap policies.
It’s in their financial interest to enroll you in a Medicare Advantage plan, not to warn you about the long-term consequences.
What To Do Before Choosing Medicare Advantage
If you’re turning 65, think carefully before enrolling in Medicare Advantage. I’ve seen too many people regret their decision to enroll in Medicare Advantage because they weren’t fully informed. It’s often too late once they realize the limitations and want to switch to Medigap.
Ask yourself these questions:
- Do you want the freedom to see any doctor or specialist without referrals or network restrictions?
- Do you want predictable out-of-pocket costs without surprise copays and high deductibles?
- Are you willing to risk being locked out of a Medigap plan in the future due to health issues?
If you value flexibility, lower long-term costs, and peace of mind, enrolling in a Medigap plan while you have guaranteed issue rights is better, even if it means paying a monthly premium.
Make sure you weigh all your options carefully. This is one decision you don’t want to get wrong. If you have questions, speak with someone who will give you unbiased advice – not just an agent trying to sell you the highest-commission plan.
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Bonus tip:
If you currently have a Medigap policy and decide to switch to a Medicare Advantage plan for the first time but later find that you’re unsatisfied with your new plan, there is a trial right period of 12 months.
You can switch back to your previous Medigap policy if the same insurance company still offers it during this trial period.
Bottom Line: Medigap Wins
While Medicare Advantage might seem attractive with its low or zero premiums, it often comes with limited provider networks, higher out-of-pocket costs, and referral requirements.
Medigap gives you predictable costs, nationwide coverage, and the freedom to see any doctor who accepts Medicare.
If you can qualify for a Medigap plan—especially during your initial enrollment period or a guaranteed issue right—it’s usually the more flexible, reliable, and cost-effective option in the long run.
For personalized advice on your plan options, contact one of our licensed insurance agents. We’ll walk you through the details, recommend plans that fit your needs, and help make the transition easy.
Sources: How Medigap Works | How to Enroll | AEP Info | Medicare Advantage
FAQs
- Can you cancel Medicare Advantage at any time?
- Why do people choose Medigap over Medicare Advantage?
- Can I drop my Medicare Advantage plan and go back to Original Medicare?
- Why are doctors and hospitals dropping Medicare Advantage?
- How much does Medigap Plan G cost?
