by Russell Noga | Updated November 22nd, 2023
Do you have a Medicare Advantage Plan? You might wonder, “Can I switch from Medicare Advantage to Medigap?” While Medicare Advantage has many benefits, it’s not as comprehensive as most Medigap policies, especially Plans F, G & N. So, it makes sense to make the change if you can.
As long as you meet specific requirements, you can make the switch from Medicare Advantage to Medigap without incurring any penalties for canceling your policy. This post discusses making the switch from Medicare Advantage to Medigap.
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What's the Difference Between Medicare Advantage and Medigap?
Medicare Advantage plans in 2025 offer comprehensive coverage. Medigap plans, however, are different types of medical insurance policies. Medigap plans are complementary coverage bolstering your Original Medicare Parts A & B policies. You need to be enrolled in Parts A & B to qualify for Medigap, and you have a range of ten plans to choose from.
Medicare Advantage replaces your Original Medicare Parts A & B benefits. You get Medigap, and Medicare Advantage plans from private healthcare insurers, while Original Medicare is a government-funded program for American seniors. Medicare Advantage and Medigap have two different enrollment periods, and you’ll need to apply during the enrollment periods to get the best deal on either policy.
Medicare Advantage plans cover everything Original Medicare covers, and some may offer extra benefits for vision, dental, and hearing services. In some cases, Medicare Advantage also covers prescription medications, whereas Medigap doesn’t cover any of these offerings.
However, Medigap plans cover all or some of the out-of-pocket costs not covered by Original Medicare. Typically, Medicare covers 80% of the costs of healthcare services relating to parts A & B, and Medigap covers the rest.
It’s against the law for a private healthcare insurer to sell you both Medicare Advantage and Medigap policies. So, you must choose between one or the other for your healthcare requirements.
What Does Medigap Cover?
Medigap plans cover many coinsurance and deductible responsibilities not covered by Original Medicare. Each plan has a different level of coverage, denoted by a letter (A, B, C, D, F, G, K, L, M, & N). Plan F is no longer available to people newly eligible for Medicare after January 1, 2020. That’s a shame because it’s the only plan offering comprehensive coverage for Parts A & B out-of-pocket expenses, including the Part B deductible.
However, Plan G offers coverage for everything Plan F does, expect the Part B deductible. All Medigap policies provide the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
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Can I Switch from Medicare Advantage to Medigap?
Switching from Medicare Advantage to Medigap requires a process. You’ll need to end your Medicare Advantage plan and enroll in Original Medicare Parts A & B to qualify for Medigap. After completing enrollment in Medicare, you can apply for a Medigap policy.
You can end your Medicare Advantage policy during specific times of the year, such as during the Medicare Advantage Open Enrollment Period (OEP) from January 1 to March 31. There’s also the Annual Election Period (AEP) between October 15 and December 7.
Outside these qualifying periods to end your Medicare Advantage plan, you can switch between Medicare Advantage and Original Medicare if you meet special rights criteria like moving outside your plan’s service area.
If you move into a nursing facility or similar care institution, or vice versa, you can switch from Medicare Advantage to Original Medicare. However, when switching from Medicare Advantage to Original Medicare, you might lose your “guaranteed-issue rights” for enrolling in a Medigap plan.
Your guaranteed-issue rights start on your 65th birthday and last 6 months after this date. However, if you enrolled in Medicare Advantage, you can change to Medicare and Medigap within the first year of your policy without losing guaranteed issue rights.
Guaranteed issue rights are important because the insurer must accept your application to join their Medigap scheme during this period. If you lose your guaranteed issue rights, you must undergo medical underwriting before being accepted into an insurer’s Medigap scheme.
Underwriting involves disclosing your health issues to the insurer. If you have a pre-existing condition, the insurer can charge you higher-than-average premiums, institute a waiting period before activating your benefits, or outright deny you a policy.
Click here to view Medigap quotes in your area.
How Do Guaranteed-Issue Rights Assist with Switching from Medicare Advantage to Medigap?
So, without guaranteed issue rights, you could pay more for your Medigap policy than expected. However, time-limited guaranteed-issue rights last 63 days from the date of leaving your Medicare Advantage plan outside the Initial Enrollment Period.
Some of the other situations qualifying you for guaranteed issue rights to a Medigap plan include the following.
- You lost your Medicare Advantage plan due to moving outside your plan’s service area.
- The Medicare Advantage provider went bankrupt or moved away from your service area.
However, there are instances where these guaranteed issue rights may limit your selection of Medigap plans available. For example, there are ten Medigap plans, but some states might only allow you to enroll in Medigap plans with guaranteed-issue rights outside the Initial Enrollment Period.
Special enrollment periods (SEPs) can also help in making the switch between Medicare Advantage and Medigap without incurring penalties or stipulations. Examples of SEPs include the following.
- Returning to the US after residing in another country.
- Moving to a new residential address.
- Moving home after an extended stay at the hospital, skilled nursing facility, or long-term care facility.
- Completing a jail sentence.
Contact our team, and we can help you understand your guaranteed issue rights, SEPs, and whether you can make the switch from Medicare Advantage to Medigap.
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Frequently Asked Questions
Can I switch from Medicare Advantage to Medigap?
Yes, you can switch from Medicare Advantage to Medigap, also known as Medicare Supplement plans. However, there are specific guidelines and enrollment periods to follow.
When can I switch from Medicare Advantage to Medigap?
The best time to switch from Medicare Advantage to Medigap is during your Medigap Open Enrollment Period (OEP). This period lasts for six months and starts on the first day of the month in which you are both 65 years old or older and enrolled in Medicare Part B.
What is the Medigap Open Enrollment Period?
The Medigap Open Enrollment Period (OEP) is a one-time window during which you have guaranteed issue rights. This means that insurance companies cannot deny you coverage or charge you higher premiums based on your health status or pre-existing conditions.
Can I switch from Medicare Advantage to Medigap outside of the Medigap Open Enrollment Period?
If you miss your Medigap Open Enrollment Period, switching from Medicare Advantage to Medigap may be more challenging. In most cases, insurance companies will use medical underwriting, and you may be subject to health screenings, which could lead to higher premiums or even denials based on your health status.
Can I have both Medicare Advantage and Medigap at the same time?
No, you cannot have both Medicare Advantage and Medigap plans simultaneously. It is illegal for insurance companies to sell you a Medigap plan if they know you have a Medicare Advantage plan.
Can I drop my Medicare Advantage plan if I want to switch to Medigap?
Yes, you can drop your Medicare Advantage plan and switch to Medigap. However, it’s crucial to do it during your Medigap Open Enrollment Period to ensure you have guaranteed issue rights and can choose from the available Medigap plans without medical underwriting.
Can I switch from Medicare Advantage to Medigap if I move to a new state?
If you move to a new state, you may have a Special Enrollment Period to switch from Medicare Advantage to Medigap, even if you missed your initial Medigap Open Enrollment Period. In some cases, you may be eligible for guaranteed issue rights due to your move.
What are the benefits of switching from Medicare Advantage to Medigap?
Medigap plans offer more predictable out-of-pocket costs and flexibility to choose any healthcare provider that accepts Medicare patients. With Medigap, you don’t have to worry about network restrictions or referrals to see specialists.
What should I consider when switching from Medicare Advantage to Medigap?
Before switching, consider the cost, coverage, and your healthcare needs. Evaluate the available Medigap plans in your area and compare them to your current Medicare Advantage plan to ensure you’re making the right decision.
How do I switch from Medicare Advantage to Medigap?
To switch from Medicare Advantage to Medigap, first, make sure you are within your Medigap Open Enrollment Period or eligible for a Special Enrollment Period. Then, research and compare Medigap plans available in your area and enroll in the plan that best fits your needs. Be sure to cancel your Medicare Advantage plan once your Medigap coverage begins.
Consult with the Professionals on Switching from Medicare Advantage to Medigap
If you want to transition from Medicare Advantage to a Medigap policy, call us at 1-888-891-0229. Our team of fully licensed Medigap agents can assist you with making the change.
We offer a free consultation and quote on any Medigap plan in any state. If you want us to call you back, leave your contact details on our site, and we’ll get in touch with you.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.