Can I Change from Medicare Advantage to Medigap?

March 12, 2025•3 min read

Understanding Medigap and Medicare Advantage Plans

When it comes to health insurance for seniors, understanding the differences between Medigap and Medicare Advantage Plans is crucial. Medigap, also known as Medicare Supplement Insurance, helps cover the costs that Original Medicare doesn't, such as copayments, coinsurance, and deductibles. On the other hand, a Medicare Advantage Plan, known as Medicare Part C, offers an alternative way to receive your Medicare benefits through private insurance companies approved by Medicare.

Here’s a quick rundown of key points to consider:

Medigap: Supplements Original Medicare, offering additional coverage.
Medicare Advantage Plan: An alternative to Original Medicare, often including extra benefits like prescription drug coverage.
Original Medicare: Comprises Medicare Part A and Part B.

Steps to Switch from Medicare Advantage to Medigap

If you're currently enrolled in a Medicare Advantage Plan and are considering switching to Medigap, there are specific steps to follow. Here's how you can switch back to Original Medicare and enroll in a Medigap Plan:

Enrollment Period: You can switch during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year.
Switch to Original Medicare: Contact your current plan provider to disenroll from your Medicare Advantage Plan and switch back to Original Medicare.
Enroll in a Medigap Plan: Apply for a Medigap policy. Note that medical underwriting may be required unless you're in your Medigap Open Enrollment Period.

Eligibility Criteria for Medigap and Original Medicare

To buy a Medigap policy, you must be enrolled in Medicare Parts A and B. You first become eligible for Medicare at age 65. Once you sign up for Medicare, you can consider enrolling in a Medigap Plan. Remember, the best time to buy a Medigap policy is during the Medigap Open Enrollment Period, which lasts for six months starting the first month you're 65 and enrolled in Medicare Part B.

Medicare Part A and Part B: The Foundation of Your Coverage

Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Combined, these parts cover a significant portion of your healthcare needs, but not everything. This is where a Medigap Plan can help by filling the gaps left by Original Medicare.

Why Consider Switching from Medicare Advantage to Medigap?

There are several reasons why you might want to switch from a Medicare Advantage Plan to Medigap:

Comprehensive Coverage: Medigap policies can help cover out-of-pocket costs that Original Medicare doesn’t pay.
Flexibility: With Medigap, you can choose any doctor or hospital that accepts Medicare patients.
Stability: Medigap Plans are standardized, meaning the benefits are the same no matter which insurance company you choose.

When Can You Switch Back from Medicare Advantage to Medigap?

If you're not satisfied with your current Medicare Advantage Plan coverage, you may want to switch back. Keep in mind that timing is crucial. The best time to switch is during the Medicare Advantage Disenrollment Period from January 1 to February 14, when you can drop your plan and return to Original Medicare.

Medicare Advantage Plan Coverage Ends: What's Next?

Once you disenroll from your Medicare Advantage Plan, your coverage ends on the last day of the month you make the switch. After that, you can enroll in a Medigap Plan to ensure you have supplemental coverage.

Considerations Before You Get a Medigap Plan

Before you buy a Medigap Plan, consider these important factors:

Medigap Coverage: Evaluate the coverage options available and choose a plan that best suits your healthcare needs.
Premium: Medigap policies come with a monthly premium in addition to your Medicare Part B premium.
Medical Underwriting: If you're outside of your Medigap Open Enrollment Period, you may need to go through medical underwriting to determine eligibility and pricing.