Switching from Medicare Advantage to Medicare Supplement Plans
The Medicare space is really a universe of options giving people the flexibility to choose. It’s designed to allow you to change your mind about your coverage and switch to a more suitable plan for your needs when your life situation or your health needs shift, but only at specific times during the year. Let’s look at one common scenario, switching from Medicare Advantage to Medicare Supplement insurance.
How do the two differ?
The first point to make up front is that whichever type of insurance you want, you can’t enroll in a Medicare Supplement (Medigap) plan while you’re in a Medicare Advantage plan. You can keep your Medigap plan if you want to enroll in a Medicare Advantage plan, but your Medicare Supplement plan won’t help pay for your MA out-of-pocket costs.
Also known as Plan C, Medicare Advantage is offered by Medicare-approved private insurance companies, unlike federally-run Original Medicare (Parts A and B). If you join an MA plan, you’ll still get Part A and Part B coverage, but the coverage will come from a private carrier.
Some MA plans offer vision, hearing, dental, and health and wellness programs not included with Original Medicare. A few offer Part D prescription drug coverage. You likely will pay a premium for your MA plan in addition to your Part B premium.
Also privately managed, Medicare Supplement (Medigap) plans help supplement the costs of Part A and Part B. They are designed to fill gaps in coverage such as the coinsurance, copayments, and deductibles you have to pay in Original Medicare.
When are my windows to switch?
Before you can purchase a Medigap plan, you have to cancel your MA plan and re-enroll in federally-managed Medicare Parts A and B. The rules about dropping your MA plan are specific:
- You can leave your Medicare Advantage plan during the Medicare Advantage Disenrollment Period running from January 1st to February 14th
- Or, during the Medicare Advantage and Prescription Drug Annual Election Period from October 15th to December 7th
- Exceptions include if you’re moving to a nursing home, or from a care facility back to your home
As soon as you return to Parts A and B, you’re free to apply for a Medigap plan, but be aware that you may face medical underwriting that the insurer can use to raise your premium or deny you coverage.
Can I change to Medigap without underwriting?
You may be in a situation allowing you to use what are known as “guaranteed issue rights” to enroll in a Medicare Supplement plan with protection against medical underwriting. If you have a pre-existing condition, the carrier may require you to wait 6 months before you can get out-of-pocket coverage for that health condition. Coverage can be denied only if the pre-existing condition was diagnosed or treated within 6 months of the start of the plan.
Below are a few of the scenarios, which allow you to switch from a Medigap plan to an MA plan:
- In your first year of Medicare, you have a Medicare Advantage plan you don’t like and you want to replace it with a Medigap plan. Since you automatically return to Parts A and B when leaving an MA plan, you have the right to buy the Medigap plan you want
- You move out of your MA service area
- Your MA plan stops serving the area you live in
- Your plan leaves Medicare
It’s critical that you know these rights have time limits — usually within 63 days following the end of your Medicare Advantage coverage. The other restriction to be aware of is that you may be able to shop only a limited number of the 10 standardized MA plans for sale in most states.
How exactly do I dis-enroll from my Medicare Advantage plan?
Once you’ve done your research and found a Medicare Supplement plan you want, you can take one of these steps to get out of your MA plan:
- Request a disenrollment form from your Medicare Advantage plan
- Call 1-800-MEDICARE (1-800-633-4227) with the request to process your disenrollment. Someone will answer your call 24/7 in every U.S. time zone
- Visit your local Social Security office or call the Social Security Administration (1-800-772-1213) to request disenrollment Monday-Friday, 7am to 7pm in all time zones
Note that if your prior MA plan had a Plan D feature and you still need prescription drug coverage, you’ll need to pick up a stand-alone Part D plan. Remember, when applying, you can request for your Part D coverage to coincide with the start of your Medigap plan.
Please contact a medigapcoverage.com powered by pollen specialist at 1-833-245-0614 if there’s any more you want to learn about switching from Medigap to a Medicare Advantage plan. And take advantage of our instant quote engine to find your perfect plan.
Still confused? Call us!
We’re here at 833-245-0614 to answer any questions, and ready to help with any issues you might have with an insurer through the enrollment process.
Table of Contents
FAQs
What’s the difference between Medicare Advantage and Medicare Supplement plans?
Medicare Advantage, or Part C plans, are sold by the federally-run Medicare program and offer benefits you can’t get from Original Medicare — Part A and Part B. Medicare Supplement plans are sold by private insurance companies and help pay for gaps in Medicare coverage.
What’s the best time to switch from Medicare Advantage to a Medicare Supplement plan?
Before you buy a Medigap plan, you have to cancel your MA plan and re-enroll in Parts A and B. You can stop your Medicare Advantage plan during the Medicare Advantage Disenrollment Period running from January 1st to February 14th. Or, during the Medicare Advantage and Prescription Drug Annual Election Period, from October 15th to December 7th.
Is it possible to avoid medical underwriting when enrolling in Medigap?
There are various situations which allow you to use what are known as “guaranteed issue rights” to apply for a Medicare Supplement plan without medical underwriting. But if you have a pre-existing condition, the carrier may require you to wait 6 months before you can get out-of-pocket coverage for that health condition. They can deny coverage only if the pre-existing condition was diagnosed or treated within 6 months of the plan’s start.
What are the best Medicare supplement plans?
- Best overall Medicare supplement for new enrollees: Plan G.
- Best overall Medicare supplement before 2020: Plan F.
- Best low cost Medicare supplement: Plan K.
- Best alternative to Plan G Medicare supplement: Plan N.
What is a Medicare supplement plan?
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
What is the most expensive Medicare supplement plan?
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
Why is Plan F being discontinued?
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Is Plan G better than Plan F?
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
What is the best and cheapest Medicare supplement insurance?
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
Is Medicare supplemental insurance worth it?
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Do I really need supplemental insurance with Medicare?
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
What is the most popular UnitedHealthcare Medicare Supplement plan?
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
How much does Medigap insurance cost?
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
Who qualifies for Medigap?
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
Is Medigap insurance worth the cost?
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
How Much Is Medigap per month?
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.
Is Plan G the best Medigap plan?
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
Is it better to have Medicare Advantage or Medigap?
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
What is the most popular Medicare supplement plan?
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.
Does Medigap cover prescription drugs?
Since January 1, 2006, no Medigap policy came with prescription drug coverage. You have two options to get covered, enrolling in either a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage plan.