Can you change to a Medigap plan if you don’t like your Medicare Advantage plan? Yes, you can change from a Medicare Advantage plan to a Medigap plan but only during certain times of the year, and approval is not always guaranteed.
The Annual Enrollment Period (AEP) is one of the best times each year to change your Medicare coverage. This includes the option to switch from a Medicare Advantage plan to a Medigap plan. Additionally, you can change to a Medigap plan during the Medicare Advantage Open Enrollment Period. We explain both in detail below. In both cases, you may have to go through medical underwriting before being approved for a Medigap plan.
How to use AEP to change to a Medigap plan:
The first thing you need to know is that you cannot have a Medigap policy and a Medicare Advantage plan simultaneously. So Medicare requires you to leave MA first before being approved on a Medigap plan. The second thing to know is that there are only certain designated times each year when you can leave Medicare Advantage. The Annual Election Period (AEP) is one of them.
The AEP runs from October 15 to December 7 each year and many people call this time “open enrollment.” This is when most people switch Medicare Advantage or Part D drug plans. AEP is also the time to disenroll in Medicare Advantage. The easiest way to do this is to enroll in a Part D drug plan during AEP.
Enrollment in Medicare Part D drug plan automatically terminates your Medicare Advantage plan on Dec 31st of that year. This now paves the way to enroll in a Medigap plan to start on Jan 1st. But scroll down because Medigap plans are not always guaranteed to be approved. You don’t want to quit a Medicare Advantage plan and get turned down for Medigap and be left with nothing!
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How to use Medicare Advantage Open Enrollment Period to change to a Medigap plans:
Medicare Advantage Open Enrollment Period is different from AEP but you can use it to disenroll in Medicare Advantage. It runs from January 1 to March 31 each year. It is another opportunity for individuals who are enrolled in a Medicare Advantage plan to switch back to Original Medicare and potentially enroll in a Medigap plan.
Enrolling in a Part D drug plan during this time will disenroll you in your Medicare Advantage plan at the end of the month. This step is required before your new Medigap plan (if approved) can begin.
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Underwriting is Usually Required to change to a Medigap plan from MA
Underwriting is typically required when switching to a Medigap plan from an MA plan. It is the process insurance companies use to evaluate an applicant’s health and determine the risk of insuring them. During underwriting, the insurance company may ask for information about your medical history, current health conditions, and medications. They will use this information to determine your eligibility and the premium you will pay for your Medigap coverage.
They can charge you more or turn you down altogether. Each company has different underwriting guidelines so one company may approve you while another may decline with the same conditions. This is where Senior65.com comes in. We can help align you with a Medigap insurance provider that will give you the best chance of approval for your pre-existing condition.
We will also help you “time” your enrollment so that if you are not approved on any Medigap plan, you will still be able to have Medicare Advantage. It is a bit tricky but we specialize in insurance switching so we can help guide you. Give us a call at 800-930-7956.
When underwriting is not required to Change to Medigap
There are certain times when underwriting is not required when leaving Medicare Advantage and enrolling in a Medigap plan. One of these times is during your initial period that some call Medigap Open Enrollment Period (OEP) or the Medigap Guaranteed Issue Period. This is a six-month period that begins the first day of the month in which you turn 65 or older and are enrolled in Medicare Part B. During this time, insurance companies are required to sell you a Medigap policy regardless of your health status, and they cannot charge you more because of pre-existing health conditions. Additionally, they cannot refuse to sell you a policy based on your health status.
The federal government has also created a set of exceptions that guaranteed acceptance in Medigap. For example, if you move outside of your MA service area, you are guaranteed approval on any Medigap plan. Learn more by reading our article about guaranteed issue rights with Medigap.
Also, in some states, Medigap plans are available to anyone under 65 who is eligible for Medicare due to a disability. In those cases, underwriting isn’t required. Check out our Medigap for Under65 article.
Finally, other states have special enrollment rules that allow you to switch from Medicare Advantage to Medigap without medical underwriting. Check out our Ulitmate guide to Medicare Insurance Switching to see ways to change to Medigap without health review.