When can I switch from Medicare Advantage to Medigap?

A person can switch from Medicare Advantage to Medicare with Medigap at several different times.

Within 3 months of Medicare enrollment

If a person enrolls in Medicare Advantage when they first become eligible for Medicare, they can switch to Original Medicare and Medigap within the first 12 months of their plan.

This benefit protects people who find that the policy they first chose does not meet their healthcare needs. A person would still be within the Medigap enrollment window, and an insurance company cannot deny an individual a Medigap policy.

During the OEP for drug coverage

Two OEPs apply to Medicare Advantage plans. These are also when a person can drop their Medicare Advantage plan and return to Original Medicare.

The first enrollment period runs from October 15 to December 7 each year. This is the OEP for all Medicare plans, including Medicare Advantage and Medicare prescription drug coverage.

During this time, a person can return to Original Medicare. However, if they had prescription drug coverage through Medicare Advantage, they must enroll in Medicare Part D to maintain their prescription drug coverage.

During the Medicare Advantage OEP

From January 1st to March 31st each year, a person can switch from one Medicare Advantage plan to another or drop their Medicare Advantage plan altogether in favor of Original Medicare. During this time, a person can join a prescription drug plan and Medigap.

Although this period sounds similar to the OEP that runs from October to December, it works in a slightly different way. During this time, a person cannot switch from Original Medicare to Medicare Advantage. They can also not enroll in new prescription drug coverage or switch it if they already have Original Medicare.

During special enrollment periods

Special enrollment periods (SEPs) are periods during which a person can usually make changes to their Medicare plan without having a financial penalty. Examples of such changes include:

• changing addresses
• moving back to the United States after living out of the country
• living in or moving out of a nursing home or rehabilitation hospital
• being released from jail
• no longer being eligible for Medicaid

A person can contact Medicare if they are unsure whether or not they meet the SEP criteria