Does switching from Medicare Advantage to Medigap require underwriting?

Switching usually requires medical underwriting; however, certain circumstances may make you exempt, such as switching within your first 12 months of Medicare Advantage or as a result of moving outside of your area of coverage.

Can I drop Medicare Advantage and go back to original Medicare?

You can switch from Medicare Advantage to original Medicare. Once you’ve switched, you may elect to enroll in a Medigap plan.

Is Medigap better than Medicare Advantage?

Medigap offers a different range of coverage that includes copays, coinsurance, and even travel insurance. Medicare Advantage, however, is often cheaper. The ideal policy depends on the person.

Which costs more — Medigap or Medicare Advantage?

On average, Medigap monthly premiums will be more expensive than those of Medicare Advantage. On average, you can expect to pay about $150 per month for a Medigap plan and $22 for Medicare Advantage.

Can You Switch From Medicare Advantage to Medigap?

June 29, 2022 amie-clark

Author: Amie Clark | June 29, 2022

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When Can You Switch? Switching to Medigap Medicare Advantage vs Medigap Bottom Line

In most cases, you can switch your policy from Medicare Advantage to Medigap. However, you can only switch during certain times of the year. Additionally, your guaranteed-issue rights may change when you switch, making how and when you switch your plans a vital part of planning your future coverage.

Did You Know: To learn more about supplementing your Medicare coverage, be sure to read our guide, What Is Medigap?

Medicare Advantage vs. Medigap

Medicare Advantage	Medigap
Lower premiums but with copays Usually have network restrictions Usually requires referrals May include vision and hearing coverage May include prescription drug coverage	Higher premiums but no copays No network restrictions No referrals required No vision or hearing coverage No prescription drug coverage

When Can You Switch From Medicare Advantage to Medigap?

When switching from Medicare Advantage to Medigap, the first step is to drop your Medicare Advantage and return to original Medicare parts A and B. From there, you’ll need to apply for Medigap.

Generally, you can drop your Medicare Advantage plans during the following periods:

Medicare Advantage Open Enrollment Period: Jan. 1 to March 31
Annual Election Period (AEP): Oct. 15 to Dec. 7

Both of these date ranges are known as the Open Enrollment Period or OEP for Medicare Advantage. They are the best time to switch between plans. However, you can also switch from Medicare Advantage to Medigap throughout the year under special circumstances. These include:

Losing Medicare Advantage if the plan leaves your area or your provider ends its Medicare contract
Moving to or from an institution such as a nursing home
Moving outside of your plan’s service area

Even in these cases, switching from Medicare Advantage to Medigap can cause you to lose your guaranteed-issue rights. This means that by switching outside of the designated enrollment period, you will be subject to medical underwriting and could be required to pay more expensive premiums. You may even get denied coverage.

FYI: Still stumped on the differences between these policies? Then check out our detailed comparison: Medigap vs. Medicare Advantage.

Switching to Medigap Without Losing Guaranteed-Issue Rights

Guaranteed-issue rights give people the right to procure insurance policies without medical underwriting. Particularly for those with preexisting conditions, avoiding underwriting can drastically reduce the cost of your premiums. Guaranteed-issue rights (as the name implies) also guarantee that an insurer cannot deny you coverage.

Since guaranteed-issue rights are essential to getting an affordable Medigap plan, you should try to switch without losing them. The best way to do so is to apply for Medigap during the initial enrollment period designated on your Medicare card. However, if you need to switch from Medicare Advantage to Medigap, this period is likely long past.

Thankfully, there are special circumstances that could allow you to switch and maintain your guaranteed-issue rights:

If you bought your Medicare Advantage policy during the initial enrollment period, you can switch within the first 12 months of having it and get original Medicare and Medigap without losing your guaranteed-issue rights.
If you lost Medicare Advantage coverage when moving outside of your provider’s service area or they changed their coverage for your location, you can also take advantage of time-sensitive guaranteed-issue rights to reapply for original Medicare and Medigap.

These circumstances are specific, but they are designed to protect those who either don’t like their new Medicare Advantage plan or lose it through no fault of their own. Since even these situations are time-sensitive, it’s important to switch as soon as you are eligible.

How to Choose Between Medicare Advantage and Medigap

Since you cannot have both Medicare Advantage and Medigap, it’s important to weigh their differences in coverage to get the right plan for your needs.

Some of the major pros of Medicare Advantage include having more variety of benefits, including more coverage options for disability needs, long-term care, and even extra hearing and vision coverage. Additionally, Medicare Advantage plans are often much cheaper than Medigap.

However, disadvantages to having Medicare Advantage include providers that don’t accept your policy or having location-specific coverage. This means that you won’t be able to access your Advantage benefits while traveling or will lose benefits when you move. Emergency care costs are also much higher.

With respect to Medigap, its advantages include lower out-of-pocket expenses for the things it covers like coinsurance and deductibles. Medigap also has a wider umbrella of coverage, giving its policyholders access to care from any doctors who accept Medicare, even while traveling.

The disadvantages of choosing Medigap over Advantage, however, include paying more (on average) for monthly premiums and lacking coverage for prescription drug costs. Those who want prescriptions covered will also have to get an additional policy in the form of Medicare Part D.

Bottom Line

The process of switching from Medicare Advantage to Medigap is complicated by time-sensitive government enrollment procedures. The main dates to remember are Jan. 1-March 31 and

Oct. 15 -Dec. 7, which are the annual enrollment periods during which you can switch plans outside of the initial enrollment.

Except in specific circumstances, switching plans will cause you to lose your guaranteed-issue rights, which could make your new plan’s premium much higher. Providers may even deny you coverage.

It is therefore important to take advantage of your initial enrollment period to choose which plan is right for you and to only switch when you feel your new coverage benefits will outweigh the cost of switching.

To learn more about Medicare and associated insurances, be sure to check out our helpful guides:

Frequently Asked Questions

Does switching from Medicare Advantage to Medigap require underwriting?
Switching usually requires medical underwriting; however, certain circumstances may make you exempt, such as switching within your first 12 months of Medicare Advantage or as a result of moving outside of your area of coverage.
Can I drop Medicare Advantage and go back to original Medicare?
You can switch from Medicare Advantage to original Medicare. Once you’ve switched, you may elect to enroll in a Medigap plan.
Is Medigap better than Medicare Advantage?
Medigap offers a different range of coverage that includes copays, coinsurance, and even travel insurance. Medicare Advantage, however, is often cheaper. The ideal policy depends on the person.
Which costs more — Medigap or Medicare Advantage?
On average, Medigap monthly premiums will be more expensive than those of Medicare Advantage. On average, you can expect to pay about $150 per month for a Medigap plan and $22 for Medicare Advantage.