Making the Switch: A Simple Guide to Moving from Medicare Advantage to a Medicare Supplement Plan
Medicare gives beneficiaries flexibility in how they receive healthcare coverage—but choosing the right plan can make a big difference in your costs and access to care. While many people begin with a Medicare Advantage Plan (MAPD) for its added benefits and lower premiums, some later discover that a Medicare Supplement Plan (Medigap) offers better long-term value and freedom.
If you’re considering this switch, this guide will walk you through what to expect, when you can enroll, and how to avoid common pitfalls.
🧩 Medicare Advantage (MAPD) Overview
Medicare Advantage Plans are offered by private insurers and include coverage for Part A (hospital) and Part B (medical) services. Many also include:
Prescription drug coverage (Part D)
Dental, vision, and hearing benefits
While premiums are typically low, MAPDs often come with:
Network restrictions (HMO or PPO)
Copays and coinsurance for many services
Referral requirements for specialists
Potential higher costs for out-of-network care
MAPDs can be great for those with minimal health needs or who prefer lower upfront costs—but less ideal for those who travel or need frequent specialist care.
✅ What Is a Medicare Supplement Plan?
Medigap plans work alongside Original Medicare to help cover out-of-pocket costs like:
Deductibles
Copayments
Coinsurance
Key benefits include:
Nationwide access to any provider who accepts Medicare
No network restrictions
Standardized benefits regardless of insurance company
No referrals needed for specialists
For frequent travelers, snowbirds, or those who want peace of mind from unexpected medical costs, Medigap is often the preferred option.
🔄 Why Switch to a Medicare Supplement Plan?
Here are the top reasons people move from MAPD to Medigap:
Freedom to Choose Any Doctor: No networks, no referrals.
Lower Out-of-Pocket Costs: Fewer surprises, more predictability.
More Consistent Coverage: Standardized plans mean fewer coverage gaps.
Better for Travelers: Nationwide coverage makes care easier anywhere in the U.S.
📅 When Can You Make the Switch?
Switching isn’t something you can do anytime. Here are your options:
1. Annual Enrollment Period (AEP): October 15 – December 7
You can leave your Medicare Advantage plan and return to Original Medicare, then apply for a Medigap policy.
2. Medicare Advantage Open Enrollment: January 1 – March 31
If you're already in a MAPD, you can switch to Original Medicare and apply for a Supplement Plan.
3. Special Enrollment Periods (SEP)
Qualifying life events such as moving, losing employer coverage, or other changes may allow you to switch mid-year.
📝 Will You Qualify for Medigap?
Outside of your Initial Enrollment Period or specific Guaranteed Issue rights, insurance companies can:
Require medical underwriting
Deny coverage or charge higher premiums based on your health
Apply during periods where you have Guaranteed Issue Rights to avoid this risk.
🛡️ Trial Rights: A Safety Net for First-Time MAPD Users
If you joined a Medicare Advantage Plan when you first became eligible for Medicare, you may have a 12-month trial right. This allows you to switch to a Medicare Supplement Plan without underwriting if you’re unhappy with MAPD during your first year.
💲 Comparing Costs: MAPD vs. Medigap
Plan TypeMonthly PremiumOut-of-Pocket CostsDoctor ChoiceExtras (Dental, Vision)MAPDLow or $0Higher, variesLimited networkOften includedMedigap + Part DHigherLower, predictableAny Medicare doctorNot included
MAPD may seem cheaper upfront, but for those who need regular care, Medigap may save money in the long run.
📍 State-Specific Rules Matter
Some states offer extended open enrollment or year-round guaranteed issue rights. Check with your state’s Department of Insurance or a licensed agent to understand your local protections.
🤔 Is It Time to Switch?
Switching to a Medicare Supplement Plan can give you greater freedom, more predictable costs, and access to any provider nationwide. But it’s important to know the timing, rules, and your eligibility.
💬 Need help exploring your options?
Complete our free quote request form or contact us for personalized support.
Sources:
National Association of Insurance Commissioners
