Switching from Medicare Advantage to Medigap can be tricky—but for many, it’s the right move to regain flexibility and reduce out-of-pocket costs. Whether you’re unhappy with your current plan or seeking more provider freedom, understanding how and when to make the change is critical.
Skyline Benefit, a leading Medicare insurance broker in California, helps beneficiaries confidently make this transition—explaining key deadlines, enrollment periods, and whether you’ll need to go through medical underwriting.
What’s the Difference Between Medicare Advantage and Medigap?
Before switching, it’s important to understand the difference:
- Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare, often with limited provider networks and extra benefits like dental or vision.
- Medigap (Medicare Supplement) works with Original Medicare to cover deductibles, copays, and coinsurance costs.
Switching from Advantage to Medigap gives back access to any provider who accepts Medicare and reduces out-of-pocket risks—but it’s not always easy.
Can You Switch from Medicare Advantage to Medigap?
Yes—but only during specific times, and you may need to pass medical underwriting to get approved.
When Can You Make the Switch?
- Medicare Advantage Open Enrollment Period (January 1 – March 31)
- Annual Election Period (October 15 – December 7)
- Special Enrollment Periods– In some cases, you may get a special right to switch if your Advantage plan leaves your area.
Will You Be Approved for a Medigap Plan?
Here’s the catch: outside of your initial enrollment period, Medigap insurers can deny your application or charge more based on your health—unless you qualify for a guaranteed issue right.
What Is a Guaranteed Issue Right?
You may qualify for guaranteed issue if:
- You’re leaving a Medicare Advantage plan within the first 12 months of enrolling.
- Your Medicare Advantage plan ends or drops coverage.
- You move out of your plan’s service area.
If none of these apply, you’ll likely undergo medical underwriting, and approval isn’t guaranteed.
Steps to Switch from Medicare Advantage to Medigap
1. Disenroll from Your Medicare Advantage Plan
You’ll first need to drop your Advantage plan and return to Original Medicare. This must be done during the correct enrollment period.
2. Apply for a Medigap Policy
Choose the Medigap plan that fits your needs (e.g., Plan G, Plan N). Apply through a trusted broker like Skyline Benefit.
3. Wait for Approval
If you’re outside a guaranteed issue window, the insurance company may ask you health questions before approving your application.
4. Enroll in a Part D Drug Plan
Medigap doesn’t include prescription drug coverage. Be sure to enroll in a separate Medicare Part D plan to avoid penalties.
Who Should Consider Switching from Medicare Advantage to Medigap?
- You want the freedom to see any doctor who accepts Medicare.
- You’re facing high out-of-pocket costs on your Advantage plan.
- You want predictable expenses with minimal copays or coinsurance.
- You’re healthy enough to pass Medigap underwriting or qualify for guaranteed issues.
What Are the Risks of Switching?
- No guaranteed acceptance into Medigap unless you qualify.
- You may face higher premiums based on your age or health history.
- You’ll lose your built-in extra benefits like dental or vision from Medicare Advantage.
- You must buy a separate Part D plan for prescriptions.
Need Help Switching from Medicare Advantage to Medigap?
Skyline Benefit is an independent Medicare insurance broker that offers affordable and flexible Medicare options. We specialize in helping Medicare beneficiaries switch plans safely and confidently. If you’re unsure whether you’ll qualify for Medigap or when to make the move, we’ll guide you every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112