Fair Square Medicare Wordmark

Can I switch From Medicare Advantage to Medigap?

Medigap and Medicare Advantage arrows stock image
By Daniel Petkevich
Sep 14, 2022

Things You Need to Know Before Switching Plans

We all know the feeling of buyer’s remorse. This feeling is not unique to shopping for clothes; it could relate to your choice of Medicare.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.
Regarding health insurance, you might find that your current plan isn't the right fit.
Luckily, Medicare has an exchange policy — letting you switch your Medicare Advantage plan to a Medigap plan.
But before you make the switch, let's consider what you need to know and how you can start the process.

Medicare Advantage Vs. Medigap

Here's a chart that compares the two:
Visual asset.
Medigap Plan Vs. Medicare Advantage Plan
A Medicare Advantage plan replaces Original Medicare. Medicare Advantage typically has lower premiums and additional benefits, such as dental and vision services.
Medigap plans supplement Original Medicare by covering deductibles and coinsurance costs. That's why you'll often see Medigap referred to as Medicare Supplement Plans. They don't have network restrictions and don't need prior approval.

Can I Switch From a Medicare Advantage Plan to Medigap?

Yes, you can change your Medicare Advantage (MA) Plan to a Medigap Plan.
Medicare Advantage plans usually offer more benefits. But, you might want to switch to a Medigap plan if:
  • Your doctor drops from the network.
  • You're not satisfied with the benefits.
  • Getting prior approval is a burden.
  • You're moving out of your plan's service area.
  • Your plan provider moves from your area.
  • You want more flexibility to see doctors outside the network.
  • Your out-of-pocket expenses grow more than you expected.
While making the switch can be simple, you don't want to cancel your MA plan and later find out that you're not eligible for the Medigap plan of your choice.
Also, make sure you switch plans during one of the specified periods (detailed below).

When Can I Switch From Medicare Advantage to Medigap?

‎You can change to Medigap while still enrolled in a Medicare Advantage plan. However, you'll almost always have to switch during one of these specified periods:
  • Open Enrollment Period: January 1st – March 31st
  • Annual Election Period: October 15th – December 7th
Here's the catch: If you enroll during one of these periods, you must undergo

medical underwriting

. Then, if you qualify, you can enroll in the Medigap Plan of your choice. (Health requirements and qualifications differ from one insurance company to another).
Switching plans during any other time of the year is only possible if:
  • You've moved out of your plan's service area.
  • Your insurance provider ends its contract with Medicare.
  • You enrolled in a Medicare Advantage plan during your initial enrollment period (when you turned 65), and you want to switch back to your Original Medicare within the first 12 months.
  • You had a Medigap plan before enrolling in the Medicare Advantage plan, and you want to switch back within the first 12 months.

Can Medigap Be Denied?

Short answer: Yes, your Medigap application could be denied.
When you apply for a Medigap plan, you'll have to answer health questions and undergo medical underwriting. Your insurance provider will accept or reject your application based on your medical history.
So, there's no guarantee that you'll be approved for Medigapunless you have "

Guaranteed Issue Rights

" or "trial rights."
Guaranteed Issue Rights protect you in the following ways:
  • You won't go through medical underwriting.
  • Insurance companies can't reject your application or charge you more due to medical reasons, including pre-existing conditions.
You have Guaranteed Issue Rights if any of the following apply:
  • You move out of your plan's service area.
  • Your old insurance plan stops providing service.
  • You return to Original Medicare within 12 months of joining a Medicare Advantage Plan (at age 65).
  • You had a Medigap plan before enrolling in the Medicare Advantage plan, and you want to switch back within the first 12 months.

How to Switch From a Medicare Advantage Plan to Medigap

First, make sure a Medigap plan will cover all your needs. In some cases, you may need to get additional coverage.
For example, if your current Medicare Advantage Plan covers prescription drugs, you'll have to add Medicare Part D with your Medigap plan to get drug coverage.
To avoid any hurdles while switching plans, follow these steps in order:
  1. Apply for a Medigap Plan
  2. Wait for approval
  3. Get Approved
  4. Unenroll from your Medicare Advantage Plan
  5. Enroll in Part D
Visual asset.
Order for Switching From Medicare Advantage to Medigap Plan
Due to the medical underwriting requirement, approval for Medigap coverage takes time. Make sure to apply early during the Annual Election period so you will have plenty of time to enroll in Part D before the period ends.

Takeaway

Medicare lets you switch health insurance plans if you're dissatisfied with your current one.
Both Medicare Advantage and Medigap have their pros and cons. Understand the benefits and drawbacks of each before choosing which plan works best for you.
If you decide to switch, follow the correct procedures to avoid losing health insurance coverage. And if you have a pre-existing condition, make sure you understand the health requirements of each Medigap Plan before applying.
If you're unsure where to begin, talk to our

insurance advisors

at (888) 376-2028. They know the ins and outs of each plan and will gladly guide you through the process.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Senior man receiving care from an optometrist stock photo
Does Medicare Cover Cataract Surgery?
Dec 22, 2022
Mental health stock photo
Does Medicare Cover Mental Health?
Oct 12, 2022
Teenager Helping his Grandfather at Home stock photo
Does Medicare Cover Geri Chairs?
Dec 7, 2022
Arizona desert stock photo
13 Best Ways for Seniors to Stay Active in Phoenix
Mar 6, 2023
treehouse
Medigap vs. Medicare Advantage
May 25, 2020
Cover image
What People Don't Realize About Medicare
Mar 27, 2023
Illustrated representation of medical marijuana, using a prescription bottle with a marijuana leaf on the front.
Does Medicare Cover Medical Marijuana?
Jan 6, 2023
senior couple working in a greenhouse stock image
Medicare Supplement Plans for Low-Income Seniors
Mar 23, 2023
woman sitting up in bed experiencing back pain stock photo
Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022
Cover image
Welcome to Fair Square's First Newsletter
Feb 28, 2023
cartoon hospital and male doctor stock image
Can I Have Two Primary Care Physicians?
Oct 3, 2022
Cover image
Does Medicare cover Hyoscyamine?
Nov 30, 2022
senior man with his glasses in his hand working in front of his laptop stock photo
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Sep 19, 2022
Acute psoriasis on elbows is an autoimmune incurable dermatological skin disease stock photo
Does Medicare Cover Light Therapy for Psoriasis?
Jan 17, 2023
Cover image
Does Medicare Cover Cold Laser Therapy (CLT)?
Jun 14, 2023
Dames Point Bridge in Jacksonville, Florida stock image
13 Best Ways for Seniors to Stay Active in Jacksonville
Mar 3, 2023
Diagnosis overactive bladder stock image
Does Medicare Cover PTNS?
Dec 9, 2022
Close up top view of a woman showing a round-shaped Lipoma fatty tumor on an open palm stock photo
Does Medicare Cover Lipoma Removal?
Dec 8, 2022

More of our articles

14 Best Ways for Seniors to Stay Active in Washington, D.C.

20 Questions to Ask Your Medicare Agent

2023 Medicare Annual Election Period (AEP)

2024 Cost of Living Adjustment

Can I Use Medicare Part D at Any Pharmacy?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Costco Pharmacy Partners with Fair Square

Does Medicare Cover an FMT?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover COVID Tests?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Flu Shots?

Does Medicare Cover Hoarding Cleanup?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Ilumya?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Jakafi?

Does Medicare Cover Krystexxa?

Does Medicare Cover Nuedexta?

Does Medicare Cover Ofev?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Oxybutynin?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Qutenza?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover SIBO Testing?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover Xiafaxan?

Does Medicare Cover Zilretta?

Does Medicare Pay for Funeral Expenses?

Does Medicare pay for Opdivo?

Does Medicare Require a Referral for Audiology Exams?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Does Your Medicare Plan Cover B12 Shots?

Fair Square Bulletin: We're Revolutionizing Medicare

Finding the Best Vision Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Can I Get a Replacement Medicare Card?

How Does Medicare Cover Colonoscopies?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Medicare Costs Can Pile Up

How Much Does Medicare Part A Cost in 2023?

How Much Does Rexulti Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How to Become a Medicare Agent

How to Enroll in Social Security

Is Displacement Affecting Your Medicare Coverage?

Is Fair Square Medicare Legitimate?

Is Gainswave Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare 101

Medicare Advantage MSA Plans

Medicare Consulting Services

Medicare Explained

Medicare Savings Programs in Kansas

Plan G vs. Plan N

The Easiest Call You'll Ever Make

The Fair Square Bulletin: February 2024

The Fair Square Bulletin: July 2023

Top 10 Physical Therapy Clinics in San Diego

What Are Medicare Part B Excess Charges?

What Does Medicare Cover for Stroke Patients?

What If I Don't Like My Plan?

What's the Difference Between HMO and PPO Plans?

Why Is Medicare So Confusing?

Why You Should Keep Your Medigap Plan

Will Medicare Cover Dental Implants?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2024

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2024 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M