If you are enrolled in a Medicare Advantage plan, you may be wondering if you can change to a Medigap policy. The answer is yes – but there are some things you need to know before making the switch.

Switching from Medicare Advantage to Medicare Supplement

Medicare Advantage is very different from Medicare Supplement. Advantage plans are alternatives to Original Medicare (Part A and Part B) benefits through a private insurance company. Usually, these will cover some or all of your Part A and Part B deductibles and coinsurance. They may also offer some extra benefits like dental, vision, and hearing coverage.

Medigap policies are designed to work alongside Original Medicare (Parts A and B). These plans help pay for things like deductibles, copayments, and coinsurance.  Medigap plans do not offer extra benefits like dental, vision, and hearing coverage.

As a result, some people find that when their needs change, they want to change from Medicare Advantage to Medigap. The good news is, you can. There is an enrollment period for it, and the person in question will first need to disenroll from Medicare Advantage by contacting their insurance company.

If the person has already had a Medigap plan before Medicare Advantage, has only been enrolled in Medicare Advantage for less than a year, and wants to return to Medigap, they can return to their old policy if the insurance company is still offering the same policy.

Finally, if someone wants to change from Medicare Advantage to Medigap and has never been enrolled in a Medigap plan in the past, Medicare.gov, State Health Insurance Programs, insurance brokers, and online plan finders like Hellahealth’s Personal Shopper can all help them to get a good Medigap quote before switching.

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Can you switch from Medicare Advantage to Medigap without underwriting?

In general, if you want to change from Medicare Advantage to Medigap, you will have to go through underwriting. This means that the insurance company will review your medical history and decide whether or not to approve you for coverage.

However, there are a few circumstances in which you may be able to change from Medicare Advantage to Medigap without it. For example, if you are moving out of the service area for your Medicare Advantage plan, you may be able to change to a Medigap policy without going through underwriting.

In addition, if your Medicare Advantage plan is being discontinued and you do not have any other coverage options, you may also be able to change to a Medigap policy without underwriting.

If you are eligible to change from Medicare Advantage to Medigap without underwriting, you will have a six-month window in which you can enroll in a Medigap policy. This is known as a “Medigap open enrollment period.”

When can you switch from Medicare Advantage to a Medicare Supplement?

There are a few different times when you can change from Medicare Advantage to Medigap.

If you want to switch outside of those periods, you may be able to do so if you have a “qualifying event.” Qualifying events include things like:

  • Moving out of your Medicare Advantage plan’s service area;
  • Losing other creditable coverage;
  • Your Medicare Advantage plan discontinuing its contract with Medicare.

One thing to pay attention to is your “guaranteed issue rights,” which is the right to buy a Medigap policy sold within your state, without being charged a higher price for any health status you may have. This right is available to you during your Medigap open enrollment period and other special circumstances.

There are two times you can keep your time-limited guaranteed-issue rights outside of the Initial Enrollment Period. This is usually time-sensitive and runs up to 63 days from the time you disenroll from the Medicare Advantage Plan.

The first case is if you bought your Medicare Advantage when you were first eligible for Medicare but changed your mind within 12 months. This will let you keep your guaranteed-issue rights when switching to Original Medicare with a Supplement.

The second is if you moved outside your plan’s service area, or for some reason or another, your plan stopped operating in the area where you live.

Older Americans may be worried that they could lose their health insurance coverage if they change from Medicare Advantage to Medigap. This is not the case as long as they enroll in a Medigap policy during their six-month Medigap open enrollment period and pay close attention to those periods and conditions that apply to them.

The best way to change from Medicare Advantage to Medigap

The best way to make the important change from Medicare Advantage to Medigap is with the help of a well-qualified insurance advisor.

A good advisor will help you understand your rights and make sure you enroll in the best Medigap policy for your needs. They can also help to get you a good Medigap quote before switching.

If you are thinking about making the change from Medicare Advantage to Medigap, contact Hellahealth today.