Can I Change from Medicare Advantage to Medigap?

Understanding Medicare Advantage and Medigap

If you’re currently enrolled in a Medicare Advantage Plan but are considering a switch to a Medigap Plan, you’re not alone. Many individuals weigh the benefits of making this switch to better align with their healthcare needs. At Overton Agency, we’re here to help you understand your options and make an informed decision.

What is a Medicare Advantage Plan?

A Medicare Advantage Plan (Part C) is an alternative to Original Medicare. These plans are offered by private insurance companies and bundle services covered under Part A and Part B, often including additional benefits such as prescription drug coverage.

What is Medigap?

Medigap (Medicare Supplement Insurance) helps cover out-of-pocket costs not included in Original Medicare, such as copayments, coinsurance, and deductibles. These plans are also sold by an insurance company but offer different benefits compared to Medicare Advantage Plans.

Why Switch from Medicare Advantage to Medigap?

There are several reasons you might want to switch from Medicare Advantage to Medigap. You may be looking for more comprehensive coverage or flexibility in choosing healthcare providers.

More predictable healthcare costs
Freedom to see any doctor that accepts Medicare
Less complex billing

When Can You Make the Switch?

To switch back to Original Medicare and gain Medigap coverage, there are specific periods known as the Medigap open enrollment period and the Medicare open enrollment period.

Medicare Annual Enrollment Period (AEP)

Occurs annually from October 15 to December 7. During this time, you can switch from a Medicare Advantage Plan to Original Medicare, making you eligible to apply for a Medicare Supplement Insurance plan.

Medigap Open Enrollment Period

This is a one-time, 6-month period that starts the month you are both 65 or older and enrolled in Medicare Part B. During this time, you can purchase any Medigap policy sold by an insurance company in your state without medical underwriting. After this period, you may need to answer health questions and could be charged higher rates or denied coverage based on your health.

Steps to Switch from Medicare Advantage to Medigap

Step 1: Disenroll from Your Current Medicare Advantage Plan

To start, contact your Medicare Advantage Plan to learn how to disenroll. This can usually be done during the Medicare Open Enrollment Period.

Step 2: Enroll in Original Medicare

Once you’ve disenrolled from your Medicare Advantage Plan, you’ll need to enroll in Original Medicare (Parts A and B). Keep any documents with your original Medicare details handy.

Step 3: Obtain Medigap Coverage

After returning to Original Medicare, you can apply for a new Medigap policy. It’s important to apply during the Medigap open enrollment period to have the best choice of plans at the best prices. You may need to answer a few questions about your health if applying outside this period.

Special Considerations

If you’re switching from a Medicare Advantage Plan for the first time within the past 12 months, you have special protections. During this time, you can switch back to an insurance plan with guaranteed-issue rights without medical underwriting.