Key Takeaways

• Switching between Medicare Advantage and Medicare Supplement is possible, but there are timing restrictions and coverage implications you must understand first.

• The decision you make can impact your healthcare access, out-of-pocket costs, and ability to change plans again in the future.

Why People Consider Switching

If you’re enrolled in Medicare and thinking about switching from a Medicare Advantage plan to a Medicare Supplement policy—or vice versa—you’re not alone. Many people reach a point where their current plan no longer meets their needs, and the idea of better flexibility or lower costs becomes appealing. But switching isn’t always as easy as you might expect.

Several reasons prompt people to consider switching, including:

• A change in health status requiring broader provider access

• Rising out-of-pocket costs under the current plan

• Desire to avoid network restrictions

• Frustration with prior authorization requirements

• Seasonal evaluation during Medicare’s annual enrollment periods

Before you make the switch, it’s important to understand the major differences between these two types of coverage—and what happens when you move from one to the other.

How Medicare Advantage and Supplement Plans Work

Medicare Advantage

Medicare Advantage (Part C) replaces Original Medicare and often includes additional benefits like vision, dental, and hearing. These plans are offered by private companies that contract with Medicare.

• You usually pay a monthly premium in addition to your Part B premium

• Most plans use provider networks

• You may need referrals to see specialists

• You’re subject to an annual out-of-pocket maximum for covered services

Medicare Supplement (Medigap)

Medigap plans work alongside Original Medicare, helping cover costs like deductibles, coinsurance, and copayments.

• You can see any provider nationwide who accepts Medicare

• You may have higher monthly premiums

• No network restrictions or referrals required

• There’s no out-of-pocket maximum, but most major expenses are covered

Understanding how each plan works can help you identify which structure better suits your current and future health needs.

When You Can Switch

Timing is critical when it comes to switching between Medicare Advantage and Medicare Supplement. Not all switches are allowed year-round, and your eligibility may depend on your health status.

Annual Enrollment Period (AEP)

• When: October 15 to December 7 each year

• What You Can Do: Switch from Medicare Advantage to Original Medicare (and apply for a Medigap policy), or vice versa

Medicare Advantage Open Enrollment Period (MA OEP)

• When: January 1 to March 31

• What You Can Do: If you’re already in a Medicare Advantage plan, you can switch to another Medicare Advantage plan or drop it and return to Original Medicare (and apply for a Medigap policy)

Special Enrollment Periods (SEP)

Certain life events like moving, losing other coverage, or plan termination can trigger a Special Enrollment Period. Rules vary depending on the situation.

Switching From Medicare Advantage to Medigap

This switch tends to be more complex. If you want to leave a Medicare Advantage plan and buy a Medigap policy, you need to:

• Disenroll from your Advantage plan and return to Original Medicare

• Apply for a Medigap policy

But here’s the catch: In most cases, unless you’re within your 6-month Medigap Open Enrollment Period (which starts when you first enroll in Part B), or you qualify for a guaranteed issue right, insurers can deny you coverage or charge more based on health.

Guaranteed Issue Rights

These rights protect you from medical underwriting, allowing you to buy a Medigap policy regardless of your health. Some cases where these rights apply:

• Your Medicare Advantage plan is leaving your area or ends coverage

• You move out of your plan’s service area

• You joined an Advantage plan for the first time and switch within 12 months

Without these protections, you may be declined or face higher premiums if you have preexisting conditions.

Switching From Medigap to Medicare Advantage

This process is more straightforward. You simply:

• Apply for a Medicare Advantage plan during a valid enrollment period

• Drop your Medigap policy once the Advantage plan coverage begins

Keep in mind:

• You may lose access to certain providers

• You may need prior authorizations for some services

• You may face out-of-pocket costs you didn’t have under Medigap

Also, if you want to switch back to Medigap later, you might not get the same plan or pricing.

Cost Considerations When Switching

Costs can vary significantly between the two options:

Medicare Advantage:

• Lower monthly premiums in some cases

• Copayments and coinsurance for many services

• Out-of-pocket maximums to protect from catastrophic costs

Medicare Supplement:

• Higher monthly premiums

• Little to no cost-sharing for covered services

• No out-of-pocket limit, but you’re shielded from major expenses through coverage

Think about both your monthly budget and your potential for high healthcare usage when weighing costs.

Provider Access and Care Coordination

The choice between Medicare Advantage and Medigap often comes down to how you prefer to access care.

• Medicare Advantage: You typically have to use network providers. If you see out-of-network doctors, your care may not be covered, or you’ll pay more. These plans often require a primary care provider and referrals.

• Medigap: You can see any provider in the U.S. who accepts Medicare, without needing referrals or worrying about network limitations.

If you travel frequently or split time between states, Medigap may offer more flexibility.

Prescription Drug Coverage Implications

When switching plans, you need to ensure you maintain prescription drug coverage:

• Medicare Advantage: Most include Part D prescription drug coverage.

• Medigap: You’ll need to enroll separately in a stand-alone Part D plan.

If you switch from a Medicare Advantage plan to Original Medicare and don’t sign up for a Part D plan within 63 days, you may face a late enrollment penalty.

Common Missteps to Avoid

Switching can be beneficial—but it also comes with pitfalls. Be aware of these common mistakes:

• Not verifying whether you’re eligible for a guaranteed issue Medigap plan

• Dropping Medigap before confirming acceptance into a Medicare Advantage plan (or vice versa)

• Ignoring provider access differences

• Forgetting to enroll in drug coverage when moving to Medigap

• Assuming you can switch back at any time with the same terms

Do your research and plan ahead to avoid surprises.

Questions to Ask Before Making a Change

Before making a switch, take time to evaluate your current and future needs. Ask yourself:

• How often do I see specialists?

• Am I comfortable with a provider network?

• Do I need coverage that travels with me?

• What’s my monthly budget for premiums?

• Would high out-of-pocket costs impact me financially?

• Do I qualify for guaranteed issue rights?

• What are my costs under each option?

Being honest about your answers can help clarify the best path forward.

Make Your Choice With Confidence

Switching between Medicare Advantage and Medicare Supplement plans can be an effective way to align your healthcare coverage with your needs—but only if you fully understand the process, timing, and possible implications. Once you switch, getting back to your previous setup may not be simple, especially if you develop health issues.

Take the time to weigh your options carefully, and reach out to a licensed agent listed on this website if you’d like professional guidance to make a smart, confident choice.