Can I Switch From Medicare Advantage to Medigap? What to Know
Can you switch from Medicare Advantage to Medigap? Learn about enrollment periods, guaranteed-issue rights, state rules, and what to know before switching.
Can You Switch From Medicare Advantage Back to Medigap?
Yes, you can switch from Medicare Advantage back to Original Medicare, but getting a Medigap policy at the same time is not always guaranteed. In most states, insurers can use medical underwriting unless you have a guaranteed-issue right. Original Medicare leaves you responsible for certain deductibles and coinsurance without an annual out-of-pocket limit on its own.
Leaving Medicare Advantage and qualifying for Medigap are two separate issues. Your enrollment period may allow you to return to Original Medicare, but it does not necessarily guarantee that a Medigap insurer will accept you. Before dropping your Medicare Advantage plan, check whether you qualify for a federal trial right or another guaranteed-issue protection, and confirm the current rules in your state. That extra step can help you avoid returning to Original Medicare without the supplemental coverage you expected.
Why Retirees Want to Leave Medicare Advantage
Medicare Advantage can be a good fit for some people, but circumstances change. A plan that worked well when you were healthy may become less convenient after a new diagnosis or a change in your medical needs.
For example, you may discover that a preferred specialist is outside your plan’s network. You might also find that a particular hospital or cancer center you want to use is not included. Prior authorization requirements can become another concern, particularly when you need more frequent or specialized care.
Costs can also be a reason to reconsider your coverage. Even when a Medicare Advantage plan has a relatively low monthly premium, copayments and other cost-sharing amounts can add up when you use more medical services.
This creates an important issue: the time when you most clearly see the limitations of a Medicare Advantage plan may also be the time when qualifying for Medigap becomes more difficult. Medigap works differently. It supplements Original Medicare by helping pay certain Medicare-covered out-of-pocket costs, including coinsurance, copayments, and deductibles.
The Two Windows When You Can Leave Medicare Advantage
There are two major annual enrollment periods to understand.
Enrollment period | What you can do | When coverage changes |
Medicare Advantage Open Enrollment Period | Leave your Medicare Advantage plan and return to Original Medicare, or change to another Medicare Advantage plan | Generally the first day of the month after the request |
Annual Enrollment Period | Leave Medicare Advantage, join another Medicare Advantage plan, or make other Medicare coverage changes. | January 1 of the following year |
Knowing which enrollment window applies to your situation is important because the timing of your request determines when you can leave Medicare Advantage and when your new coverage takes effect.
The Medicare Advantage Open Enrollment Period (Jan. 1–March 31)
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 and is available to people who are already enrolled in Medicare Advantage. You can make one change during this period. If you return to Original Medicare, you can also enroll in a separate Part D prescription plan.
The Medicare Advantage Open Enrollment Period gives people already enrolled in a Medicare Advantage plan a limited opportunity to make a change during the year. If you apply during this window, you won’t have to wait until the next Annual Enrollment Period if your current plan no longer meets your needs.
The Annual Enrollment Period (Oct. 15–Dec. 7)
The Annual Enrollment Period runs from October 15 through December 7. This is the main fall window for people with Medicare to review their coverage and make changes for the coming year. During this period, you can leave Medicare Advantage and return to Original Medicare, switch to another Medicare Advantage plan, or make other Medicare coverage changes. Changes typically take effect January 1 of the following year.
If you return to Original Medicare and want prescription drug coverage, you’ll also need to consider Part D. Choosing a Part D plan during this enrollment window can help you maintain prescription drug coverage and avoid a potential late enrollment penalty if you otherwise go without creditable drug coverage.
Keep in mind that leaving Medicare Advantage during the Annual Enrollment Period does not automatically give you the right to buy a Medigap policy without medical underwriting. Medigap rules depend on factors such as when you first became eligible for Medicare and whether you have a guaranteed-issue right.
Leaving Advantage Is Easy — Getting Medigap Is Not
This is the most important part of the decision. Leaving Medicare Advantage and returning to Original Medicare is one step. Getting a Medigap policy to supplement Original Medicare is another.
Outside your initial six-month Medigap Open Enrollment Period or a qualifying guaranteed-issue situation, an insurance company may use medical underwriting. Medicare explains that insurers do not have to sell you a Medigap policy after your open enrollment period unless a specific protection applies.
That means someone could leave Medicare Advantage, return to Original Medicare, and then discover that a Medigap application is denied. Original Medicare by itself does not have an annual out-of-pocket maximum for covered Part A and Part B services. Medigap can help cover many of those costs, but it is not automatically available to everyone who leaves Medicare Advantage.
Medical Underwriting When Switching to Medigap
Medical underwriting means an insurance company can consider your health history when deciding whether to sell you a Medigap policy, depending on your circumstances and state rules.
An application may ask about conditions and recent treatment, such as cancer, heart disease, stroke, chronic lung conditions, or diabetes complications. Each insurer can have its own underwriting standards, so the result can vary between companies.
Depending on the circumstances, an application could be approved at the standard rate, approved with a higher premium, or denied. Medicare notes that outside protected enrollment situations, an insurer may deny an application if the applicant does not meet its medical underwriting requirements.
This is why it is risky to assume that simply leaving Medicare Advantage guarantees access to Medigap.
The 12-Month Trial Rights for Medigap Switchers
Federal law provides important trial rights for certain people who are trying Medicare Advantage for the first time. These protections can allow someone to return to Original Medicare and obtain Medigap without going through ordinary medical underwriting.
Trial Right 1 — You Joined Advantage When First Eligible at 65
If you joined a Medicare Advantage plan—or enrolled in the Program of All-Inclusive Care for the Elderly (PACE)—when you were first eligible for Medicare Part A at age 65, then you have a 12-month trial period. If you decide during that period that Medicare Advantage is not right for you, you can return to Original Medicare and have a guaranteed-issue right to buy a Medigap policy sold in your state.
Importantly, the 12-month deadline applies to your decision to leave the Medicare Advantage plan or PACE and return to Original Medicare. It doesn’t necessarily mean your Medigap application must be submitted by the 12-month anniversary. Medicare allows you to apply as early as 60 days before your coverage ends and no later than 63 days after it ends. In other words, your Medigap application can be submitted after the one-year mark if you exercised your trial right within the required period and remain within the applicable application window.
According to this timing distinction, the trial right protects your ability to buy Medigap, while the separate application window determines when you can actually submit the application.
Trial Right 2 — You Dropped Medigap to Try Advantage for the First Time
There is another trial right for people who previously had Medigap, dropped it to join Medicare Advantage for the first time, and decide within 12 months to return to Original Medicare. Medicare describes this as a “trial right” and says the opportunity to leave Medicare Advantage lasts for 12 months after first joining the plan.
In this situation, you may be able to get your former Medigap policy back if the insurer still sells it. If that policy is no longer available, federal rules may give you the right to purchase certain other Medigap policies. The specific options can depend on when you became eligible for Medicare and applicable state rules.
This trial right is tied to your first time joining Medicare Advantage after having Medigap. Joining another Medicare Advantage plan later does not create a new 12-month trial period. Medicare describes this as a “single 12-month period” when you first drop Medigap to join Medicare Advantage.
Why the Trial Right Expires Quietly
There is no reason to assume that Medicare will remind you as the deadline approaches. Medicare’s guidance puts the responsibility on you to understand when your trial period ends and to act within the applicable deadlines. The trial right lasts for 12 months after you first join Medicare Advantage, and the separate Medigap application window generally runs from 60 days before your Medicare Advantage coverage ends through 63 days afterward.
Timing-wise, an application made while you have a guaranteed-issue right can receive different treatment from one made after that protection has expired. When you have a guaranteed-issue right, the insurance company generally can’t use your answers to medical questions to deny you a Medigap policy or change the price. Outside a protected enrollment situation, an insurer may be allowed to use medical underwriting and deny the application.
In practical terms, the difference between applying while you’re still protected and applying after that protection has ended can be significant. For someone who waits beyond the applicable guaranteed-issue window, an insurer may be able to deny the application based on medical underwriting. State law can provide additional protections, so the exact outcome varies by situation.
Medigap trial rights
Your 12-month trial right, mapped
The trial right covers your decision to leave Medicare Advantage. A separate window controls when you can submit your Medigap application.
Trial right 1
You joined Advantage when first eligible at 65
- Applies if you joined a Medicare Advantage plan or PACE when first eligible for Part A at 65.
- Within 12 months, you can return to Original Medicare.
- You get a guaranteed-issue right to buy a Medigap policy sold in your state.
Trial right 2
You dropped Medigap to try Advantage for the first time
- Applies the first time you leave Medigap to join Medicare Advantage.
- Within 12 months, you can return to Original Medicare.
- You may get your old policy back if it’s still sold, or certain other Medigap policies if it isn’t.
No one sends a reminder. Find your Advantage coverage effective date and mark the 12-month deadline. Switching to another Advantage plan doesn’t start a new trial period.
Other Situations That Trigger Guaranteed-Issue Rights
Trial rights are not the only circumstances in which you may have guaranteed-issue protections. Federal rules also provide Medigap rights in certain situations involving changes to your existing coverage. For example, you may qualify if your Medicare Advantage plan leaves Medicare, stops providing care in your area, or you move outside the plan’s service area. Certain situations involving the loss of employer, retiree, COBRA, or union coverage can also create a guaranteed-issue right.
When one of these protected situations applies, the 63-day window can be critical. Depending on the circumstances, you generally must apply for Medigap no more than 63 days after your Medicare Advantage coverage ends. Some situations also allow you to apply during the 60 days before coverage ends. The exact window depends on why your coverage is ending, so check the notice from your plan and the applicable Medicare rules.
There can also be situations in which a Medicare Advantage plan’s actions raise separate enrollment or appeal issues. For example, CMS has addressed significant changes to Medicare Advantage provider networks and the potential special election periods and Medigap guaranteed-issue rights that may apply to affected beneficiaries. These protections are fact-specific and don’t mean that every dispute with a plan automatically creates a Medigap guaranteed-issue right.
If you believe your plan failed to follow its contract, gave you incorrect information, or misled you about your coverage or enrollment options, keep the evidence. Save plan letters and notices, emails, enrollment materials, and records of communications with the plan. Those documents can help establish what you were told, when your coverage changed, and whether a special enrollment period or other protection applies. Medicare specifically advises beneficiaries to keep letters, notices, emails, and claim denials when they may need to prove that coverage ended or establish a Medigap right.
Because these situations can be fact-specific, don’t assume that a plan error automatically extends your Medigap rights. If your plan misled you or didn’t follow the rules, you may have a guaranteed-issue right; keep documentation and confirm with your State Health Insurance Assistance Program (SHIP) to determine whether you have a protected enrollment period.
States With Stronger Medigap Protections
State rules can provide additional protections. Connecticut and New York offer broad year-round guaranteed-issue protections, while Massachusetts and Maine have specific annual enrollment rules. Massachusetts requires an annual window, but all insurers there currently offer year-round enrollment. On the other hand, Maine guarantees one month a year, though only for its most basic plan. Minnesota added its own annual window for ages 65-70 as of August 1, 2026, timed to the fall enrollment period, in addition to the Jan. 1–March 31 window, according to Kaiser Family Foundation.
One distinction trips people up constantly, and that is that birthday or anniversary rules in states like California, Idaho, and Oregon will typically let someone already on Medigap switch to a different policy. They rarely help someone coming from Medicare Advantage. Because rules shift, a call to your state insurance department or a local SHIP counselor is worth it before you act.
What You Lose and Gain in the Medigap Switch
Moving from Medicare Advantage to Original Medicare with Medigap can change how you access and pay for care. With Original Medicare, you can see any doctor or hospital that accepts Medicare anywhere in the U.S. In most cases, you also don’t need a referral to see a specialist. Unlike many Medicare Advantage plans, Original Medicare generally doesn’t require you to stay within a plan network for covered care.
The important catch is that Original Medicare by itself doesn’t have an annual out-of-pocket maximum. For Part B-covered services, you generally pay 20% of the Medicare-approved amount after meeting the Part B deductible, and there is no yearly cap on those costs. That’s where Medigap can become particularly important: Medigap policies are designed to help pay some of the deductibles, coinsurance, and other out-of-pocket costs that Original Medicare doesn’t cover. The amount of protection depends on the Medigap plan you choose.
This creates an important distinction between returning to Original Medicare alone and returning to Original Medicare with Medigap. Original Medicare provides broad provider access and, in most cases, does not require specialist referrals, but it leaves you responsible for certain cost-sharing without an annual out-of-pocket limit. Medigap can help make those costs more predictable by paying some of the expenses that would otherwise come out of your pocket.
On the other hand, Medicare Advantage plans have an annual out-of-pocket limit for covered Medicare services and may include benefits that Original Medicare and Medigap don’t, such as certain dental, vision, hearing, or fitness benefits. Many Medicare Advantage plans also include Part D prescription drug coverage. Medigap policies usually don’t include prescription drug coverage, so someone returning to Original Medicare may need a separate Part D plan.
There is no universally right choice. The important question is which coverage structure fits your healthcare needs, budget, provider preferences, and priorities—and, if you’re considering leaving Medicare Advantage, whether you can obtain the Medigap protection you’re expecting before making the switch.
Don’t Forget Part D
Prescription coverage is an easy part of the transition to overlook. Most Medicare Advantage plans that include drug coverage bundle Part D into the plan. Medigap does not replace that coverage. If you return to Original Medicare and want prescription coverage, you need to enroll in a separate Part D plan.
The good news is that, during the Medicare Advantage Open Enrollment Period from January 1 through March 31, you can make both changes within the same enrollment window. If you’re enrolled in Medicare Advantage, you can drop the plan and return to Original Medicare and join a separate Medicare drug plan during that same period. Medicare says that when you return to Original Medicare and join a Part D plan during this window, you don’t need to separately contact your Medicare Advantage plan to disenroll; the disenrollment happens automatically when you join the drug plan.
Pay close attention to the dates so you don’t create a gap in drug coverage. If you go 63 days or more in a row without Medicare drug coverage or other creditable prescription drug coverage, you may have to pay a Part D late enrollment penalty when you later enroll in Part D. The penalty is added to your monthly premium and generally continues for as long as you have Medicare drug coverage.
That means the transition isn’t just about choosing when to leave Medicare Advantage. You also need to coordinate the end of your existing drug coverage with the start of your new Part D coverage. A gap of 63 days or more without creditable drug coverage can have a financial consequence that follows you for the duration of your Part D coverage.
The Sequence of Events When Applying for Medigap
The safest way to approach a voluntary switch is to think about the steps in the right order.
Step by step
The safe order for switching from Advantage to Medigap
Follow these steps in sequence so you don’t give up your current plan before your new coverage is confirmed.
-
Check your eligibility
Find your Advantage coverage effective date. Confirm whether you have a trial right, another guaranteed-issue right, or state protection.
-
Apply for Medigap first
If medical underwriting applies, submit your application before you disenroll from Medicare Advantage.
-
Key milestone
Get written confirmation
Ask the insurer to confirm your application is accepted and the policy will be issued. A submitted application isn’t coverage.
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Coordinate effective dates
Disenroll from Advantage and join a standalone Part D plan if needed. Time Medigap to start when Advantage ends.
Don’t cancel on a pending application.Without a guaranteed-issue right, an insurer can deny Medigap based on your health history.
Avoid a 63-day drug coverage gap.Going 63 days or more without creditable drug coverage can trigger a Part D late enrollment penalty that generally lasts as long as you have Part D.
- Check your eligibility. Find your Medicare Advantage coverage effective date and determine whether you have a trial right or another guaranteed-issue protection. Check your state’s Medigap rules, too.
- Apply for Medigap first. If medical underwriting applies, submit your application before you disenroll from Medicare Advantage.
- Get written confirmation of coverage. Most importantly, don’t assume that submitting an application means you have coverage. Ask the insurer to confirm that your application has been accepted and that the policy will be issued. If you don’t have a guaranteed-issue right, an insurer may be able to deny your application based on medical underwriting.
- Coordinate the effective dates. Once your Medigap application has been accepted, arrange your Medicare Advantage disenrollment and enroll in a standalone Part D plan if needed. Your Medigap coverage can be timed to begin when your Medicare Advantage coverage ends; Medicare says Medigap coverage can’t start while you’re still enrolled in Medicare Advantage. Confirm the effective dates with both insurers so you don’t create an unintended coverage gap.
The key principle is simple: don’t cancel Medicare Advantage based solely on an application that is still pending. If medical underwriting applies, the important milestone is confirmation that the Medigap policy will actually be issued—not merely that the application was submitted.
How To Make the Call to Switch to Medigap
Switching from Medicare Advantage to Medigap is not simply an enrollment decision. It is also a timing decision. Start by identifying your Medicare Advantage coverage effective date. Then determine whether you have a trial right, guaranteed-issue protection, or a state-specific opportunity to obtain Medigap without medical underwriting.
Also compare the practical differences between your current plan and Original Medicare with Medigap, including provider access, prescription coverage, premiums, and potential out-of-pocket costs.
For 2026, the standard Medicare Part B premium is $202.90 per month, and the annual Part B deductible is $283. The Part A hospital deductible is $1,736 per benefit period. These are Medicare’s current 2026 figures, although what an individual pays can vary based on income and other circumstances.
Get Help Switching to Medigap Today!
Switching from Medicare Advantage to Original Medicare is easier when you understand your enrollment rights before making a change. Your timing can affect your Medigap options, medical underwriting, and prescription drug coverage, so it’s worth checking the details first.
You do not have to work through these rules alone. Your local State Health Insurance Assistance Program (SHIP) offers free, unbiased Medicare counseling. You can also get help through 1-800-MEDICARE (1-800-633-4227) and Medicare’s online tools. For additional retirement and Medicare education, explore the resources available through My Guide To Retirement.
Leaving a Medicare Advantage plan is a decision worth making on your own timeline, not the insurer’s. Know which enrollment window you’re in, keep your Medigap coverage start date in mind, and get written confirmation that your new policy will be issued before you give up your current plan. With the right information and a little help from a trusted source, you can make the switch with confidence and avoid surprises with your coverage.
FAQs About Switching to Medigap
You can leave Medicare Advantage during certain enrollment periods or qualifying Special Enrollment Periods. However, your ability to buy Medigap without medical underwriting is a separate question. Outside a guaranteed-issue situation, an insurer may deny your application.
Yes, in many circumstances. If you are outside a protected enrollment period, an insurer may use medical underwriting and may deny coverage based on its underwriting requirements.
Twelve months from your Medicare Advantage coverage effective date. The Medigap application window opens 60 days before your Advantage coverage ends and closes 63 days after. No one notifies you when this deadline approaches, so finding your effective date and marking your calendar is worth doing today rather than later.
Usually, yes. Medigap policies do not provide Part D prescription drug coverage, so people returning to Original Medicare need a separate Part D plan if they want prescription coverage.
You could remain on Original Medicare without Medigap. That means you would be responsible for Medicare’s applicable deductibles and coinsurance without the supplemental protection a Medigap policy can provide. This is why it is important to understand your Medigap eligibility before leaving Medicare Advantage.
No. The federal trial right is generally tied to your first experience with Medicare Advantage. Moving from one Advantage plan to another does not create a new 12-month trial period.
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