Can I Switch From Medicare Advantage to Medigap?

Yes, you can switch from Medicare Advantage to Medigap.

If you currently have a Medicare Advantage plan, you have the flexibility to switch to a Medicare Supplement plan during specific enrollment periods. This allows you to explore additional coverage options and potentially enhance your healthcare benefits.

What’s the Difference Between Medicare Advantage and Medigap?

Medicare Advantage and Medigap plans provide different levels of coverage, costs, and flexibility to beneficiaries.

Here are a few key distinctions:

• Coverage: Medicare Advantage plans often provide additional benefits that traditional Medicare does not cover, such as dental, hearing, vision, and sometimes prescription drugs. Medigap coverage, conversely, supplements the coverage you get from Original Medicare, paying for costs that Medicare does not cover, like copayments, coinsurance, and deductibles.
• Cost: With Medicare Advantage plans, you may have lower or no monthly premiums and a maximum out-of-pocket limit. Medigap plans often have higher monthly premiums but can lower out-of-pocket costs yearly.
• Choice of doctors and hospitals: In Medicare Advantage plans, you’re usually limited to the doctors and hospitals within the plan’s network. Medigap plans, however, do not have network restrictions; you can see any doctor or hospital that accepts Medicare.
• Travel: While many Medigap plans offer health insurance coverage during travel outside the United States, Medicare Advantage plans typically do not.
• Prescription drug coverage: Some Medicare Advantage plans include prescription drug coverage, while Medigap plans do not.

When Can I Switch?

There is a provision known as the “trial right” that permits new Medicare beneficiaries to switch from Medicare Advantage to a Medigap plan within the first three months. This applies only if you enrolled in Medicare Advantage when you were first eligible for Medicare.

You also have the opportunity to make changes to your Medicare plan during certain times of the year. The first period is called the Annual Election Period (AEP), from October 15 to December 7 annually. The second is the Medicare Advantage Open Enrollment Period, from January 1 to March 31 each year.

Within these specific timeframes, you can discontinue your Medicare Advantage plan, which will automatically reinstate your Original Medicare Part A and Part B coverage. Afterward, you have the option to purchase a Medigap policy through a private insurance provider approved by Medicare.

It is advisable to plan ahead and familiarize yourself with these timelines to ensure a seamless transition with your coverage.

How Do I Know What Plan Is Best For Me?

Selecting the appropriate Medicare plan is contingent upon your individual requirements. Consider factors such as desired coverage level, budgetary considerations, provider preferences, prescription drug needs, and travel care requirements.

There’s no one-size-fits-all answer when it comes to choosing a Medicare plan. It’s highly recommended to compare options and seek the advice of a licensed insurance agent to guide you in your decision-making process.

Bottom Line

Switching from a Medicare Advantage plan to a Medigap plan can give beneficiaries more flexibility and coverage options to suit their needs better.

When considering switching to a Medigap plan, it’s helpful to research different plans and compare costs, coverage, and other factors to determine the best option for you. This way, you can confidently find and enroll in the right plan.

Sources: Medicare.gov | Medical News Today | AARP

FAQs

Can I switch from Medicare Advantage to Medigap penalty-free?

Transitioning from Medicare Advantage to Medigap can be done without penalties, given that specific periods are adhered to.

What happens when I unenroll from a Medicare Advantage plan?

When you unenroll from a Medicare Advantage plan, your coverage reverts back to Original Medicare. This change does not automatically enroll you in a Medigap plan.

Can I have Medicare Advantage and Medigap at the same time?

No, you cannot have a Medicare Advantage and a Medigap plan simultaneously.