Can I Change from Medicare Advantage to Medicare Supplement and What to Expect

If you're considering switching from a Medicare Advantage plan to a Medicare Supplement plan, you're not alone. Many people make this change every year, and it's completely possible.

You can change from a Medicare Advantage plan to a Medicare Supplement plan during the annual Open Enrollment Period, which typically runs from October 15 to December 7. This is the only time of the year when you can make this switch without facing penalties.

Be aware that you may be subject to penalties if you switch outside of the Open Enrollment Period, unless you qualify for a Special Enrollment Period due to certain life events, such as moving to a new area or losing your current coverage.

Medicare Supplement plans, also known as Medigap plans, are designed to fill the gaps in Original Medicare coverage, including deductibles, copays, and coinsurance.

Medicare and Medicare Supplement, also known as Medigap, are two different types of health insurance.

Medicare is a federal health insurance program that covers hospital and medical expenses, but it doesn't cover everything, and you may need to pay out-of-pocket for some services.

You can enroll in a Medigap plan only if you have Original Medicare (parts A and B), and enrolling in Medigap is not compulsory, it's just a supplemental policy to reduce out-of-pocket costs.

Medigap serves only to reduce out-of-pocket costs, it's not a replacement for Medicare.

A person with a Medicare Advantage plan may find that they could spend less money or have more inclusive benefits if they enrolled with Original Medicare with a Medigap supplement.

You can't enroll in Medigap just anywhere, not all regions offer Medicare Advantage policies, so if you move out of an area that offers Medicare Advantage plans, you may need to find different coverage and choose to enroll in Original Medicare with a Medigap plan instead.

There's a 6-month Medigap open enrollment period (OEP) when you first enroll in Medicare Part B, during this time an insurance company can't deny you Medigap coverage based on age or any preexisting health conditions.

After the OEP ends, an insurance company doesn't have to sell you a Medigap policy, and they may charge more for it.

This is why people may find that they can save money if they sign up for Medigap within the first 6 months of when their Medicare benefits begin.

You can switch from Medicare Advantage to Medicare Supplement, but there are specific times when you can do so. You have a guaranteed issue right to buy any Medigap policy sold in your state if you signed up for Medicare Advantage and want to switch to Original Medicare in the first year of coverage.

During the Medicare Advantage Open Enrollment Period, from January 1 to March 31 each year, you can make one decision with your Medicare Advantage plan. You can change Medicare Advantage Plans or switch from Medicare Advantage back to Original Medicare and apply for a Part D prescription drug plan.

You can also switch from Medicare Advantage to Medicare Supplement during the Annual Enrollment Period, from October 15th to December 7th each year. However, you must qualify medically to switch during this time.

If you disenroll from your Medicare Advantage plan and switch back to Original Medicare, you could be eligible for one of the many types of Medigap policies. There are specific times when you can switch, including within 3 months of Medicare enrollment, during the Medicare Advantage Open Enrollment Period, and during special enrollment periods.

Here are the specific times when you can switch from Medicare Advantage to Medicare Supplement:

Note that the ability to switch depends on your situation and state, and you may be subject to medical underwriting and denials after the first year of coverage.

During the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year, you can switch from one Medicare Advantage plan to another or drop your Medicare Advantage plan altogether in favor of Original Medicare.

You can also join a prescription drug plan and Medigap during this time, but you cannot switch from Original Medicare to Medicare Advantage. This period works in a slightly different way compared to the Annual Enrollment Period.

To switch from Medicare Advantage to Medigap, you must disenroll in Medicare Advantage, enroll in Original Medicare, and apply for Medigap. The new plan will go into effect on January 1 of the following year, and you may face denials or higher costs compared to Medicare Advantage costs.

You can attempt to switch from Medicare Advantage to Medigap during open enrollment, but the process can be complex. Here are the steps to follow:

Note that you must apply for a Medicare supplement plan within 60 days after the date of the application.

To plan your switch from Medicare Advantage to Original Medicare with Medigap, it's essential to understand the enrollment periods. You can switch during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year. This period allows you to change Medicare Advantage Plans or switch back to Original Medicare and apply for a Part D prescription drug plan.

The Medigap open enrollment period begins when you first become eligible for Medicare at age 65. During this once-only period, you can enroll in any Medigap policy sold in your state without undergoing medical underwriting. This is called "guaranteed issue."

You can also switch from Medicare Advantage to Medigap during special enrollment periods, which allow you to make changes to your Medicare plan without a financial penalty. Examples of such changes include switching from Medicare Advantage to Original Medicare and applying for a Medigap policy.

If you're unhappy with your Medicare Advantage plan, you can attempt to switch to Medigap during open enrollment, but you may face denials or higher costs compared to Medicare Advantage costs. You must disenroll in Medicare Advantage, enroll in Original Medicare, and apply for Medigap.

To switch from Medicare Advantage to Medigap, follow these steps: research available Medigap plans in your area, choose the supplement plan that best fits your needs and budget, confirm your eligibility and enrollment options and periods, apply for a Medicare supplement plan, and apply for standalone Medicare Part D prescription drug coverage.

You may also be able to switch to Original Medicare and a Medicare Supplement plan if a life situation qualifies you for a special enrollment period, such as moving out of your Medicare Advantage plan's service area or losing your current coverage.

Here are some key enrollment periods to keep in mind:

It's essential to weigh the pros and cons of switching from Medicare Advantage to Original Medicare with Medigap, as it can be a cost-saving move in the long run. However, you'll need to consider the potential higher costs of Medigap premiums due to pre-existing conditions if you enroll outside of the initial enrollment period.

Medigap plans are regulated at the state level, which means that each state can have its own set of rules and requirements.

Some states offer additional consumer protections that may not be available in other states. For example, some states may have different eligibility rules for Medigap plans.

Each state's specific rules and requirements are important to understand when applying for a Medigap plan. We'll review your state's laws with you when helping you find the right coverage.

Switching from Medicare Advantage to Medicare Supplement can be a great option for some people, but it's essential to consider the pros and cons.

You'll have fewer out-of-pocket costs with a Medicare Supplement plan, making healthcare expenses more predictable. This is because Medigap policies can cover expenses like deductibles, copayments, and coinsurance.

With a Medicare Supplement plan, you'll have fewer provider limitations, allowing you to visit any doctor who accepts Original Medicare patients without needing referrals.

Medicare Supplement plans offer comprehensive coverage, filling the gaps in Original Medicare coverage, which can reduce your out-of-pocket costs for healthcare services.

You can expect to pay a higher monthly premium for a Medicare Supplement plan, which can range from $200 to over $400 per month, depending on the plan and your age.

If you're not within the first six months of your Medigap Open Enrollment Period (OEP), an insurance company may not sell you a policy, and if they do, you may have to pay a higher premium.

Here are some key benefits of switching to a Medicare Supplement plan:

If you're considering switching from Medicare Advantage to Medicare Supplement, there are some important things to keep in mind.

Switching requires a valid election period, such as the Annual Election Period, and you may pay a higher price or be denied coverage.

You can switch during the Medicare open enrollment and Medicare Advantage open enrollment periods, which are your best chances to make a change.

Plan switches are also allowed if you qualify for a special enrollment period.

It's best to enroll in Medigap when you qualify for a guaranteed issue without medical underwriting, as this can save you from facing health questions.

Switching due to losing a preferred doctor from your network or dissatisfaction with prior authorization requirements are common reasons for making a change.

Here are the key periods when you can switch: