Switching from Medicare Advantage to Medigap

You can switch from Medicare Advantage to Medigap — but there's a critical catch most people don't know until it's too late: outside of specific guaranteed issue windows, Medigap insurers can reject you or charge higher premiums based on your health history. The best time to get Medigap is during your initial enrollment window, before you've tried Medicare Advantage. After that, your options depend heavily on timing and what state you live in.

Guaranteed Issue Rights — When You're Protected

"Guaranteed issue" means an insurer must sell you any Medigap policy at the standard rate, regardless of health.

Medigap Open Enrollment Period: One-time 6-month window starting when you're 65 and enrolled in Part B. Can't be denied. This is the best time.
When your Medicare Advantage plan leaves your area or stops covering Medicare: Guaranteed issue rights to switch back to Original Medicare + Medigap.
When you move out of your plan's service area: Guaranteed issue.
When you're in a Medicare SELECT plan that reduces its service area: Guaranteed issue.
12-month trial right: If you switched from Original Medicare (with Medigap) to Medicare Advantage for the first time, you have 12 months to switch back with guaranteed issue rights. After 12 months, this protection expires.

When You're NOT Protected — The Medical Underwriting Problem

Outside of guaranteed issue periods, you'll likely face medical underwriting:

The Medigap insurer reviews your health history
They can charge significantly higher premiums
They can decline to sell you certain plans
In most states, they can reject you entirely

Conditions that commonly trigger denials or surcharges: heart disease, diabetes, COPD, cancer history, obesity, and many others.

This is the hidden cost of trying Medicare Advantage first. If your health changes while on Medicare Advantage, switching back to Medigap may become very difficult or very expensive.

State Protections — It Depends Where You Live

California: "Birthday Rule" — once per year around your birthday, can switch to an equal or lesser Medigap plan without underwriting.
Oregon: Similar birthday rule.
Missouri, Illinois, Nevada, and others: Varying additional guaranteed issue windows — check state insurance department.
New York and Connecticut: Year-round guaranteed issue. You can always switch, any time, regardless of health.

How to Switch (Step-by-Step)

Pick your switch date — must align with AEP (Oct 15–Dec 7) or MAOEP (Jan 1–Mar 31)
Apply for Medigap first — get approved (or confirm guaranteed issue) before doing anything else
Then disenroll from Medicare Advantage — your Original Medicare coverage resumes
Add a Part D plan — Medigap doesn't include drug coverage

Do NOT disenroll from Medicare Advantage before your Medigap is confirmed approved. You don't want a coverage gap.

Frequently Asked Questions

Can I switch from Medicare Advantage to Medigap at any time?

You can only switch during valid enrollment periods. More importantly, whether you'll face medical underwriting depends on your situation and state.

Can a Medigap company reject me because of pre-existing conditions?

Outside of guaranteed issue periods, yes — in most states, Medigap insurers can reject you or charge more based on health history.

What if I'm in bad health and want to switch from Medicare Advantage to Medigap?

Options depend on your state's protections and whether you qualify for any guaranteed issue windows. Worth discussing with a licensed advisor before making any changes. Match with an advisor

Is there a way to try Medicare Advantage and come back to Medigap if I don't like it?

Yes — the 12-month trial right. If you switch to Medicare Advantage for the first time and return within 12 months, you have guaranteed issue rights. After 12 months, this protection expires.

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