Can I Switch from Medicare Advantage to Medicare Supplement Insurance?
This article was updated on: 09/03/2017
If you want to change your Medicare plan options, such as switching from a Medicare Advantage plan to a Medicare Supplement plan, there are certain times when you may be able to do so. Changing Medicare plan options works differently depending on which type of Medicare insurance you have and which type you want.
Before you change from a Medicare Advantage plan to a Medicare Supplement plan, or even change Medicare Supplement plans, let’s start with a quick rundown on the difference between these types of plans.
Medicare Advantage vs. Medicare Supplement insurance
In a nutshell, Medicare Advantage (Medicare Part C) provides a way to get your Medicare Part A and Part B benefits through a private, Medicare-approved insurance company. Some plans offer additional benefits, such as routine vision care. Medicare Supplement (Medigap) plans are designed to work alongside your Original Medicare (Part A and Part B) benefits – Medicare Supplement plans don’t provide those benefits, but instead, they may help pay your Part A and Part B out-of-pocket costs.
You can’t use Medicare Supplement plans to pay your out-of-pocket costs (like copayments) from Medicare Advantage plans. In fact, if you’re already enrolled in Medicare Advantage, it’s against the law for someone to sell you a Medicare Supplement plan (unless you’re changing back to Original Medicare, Part A and Part B). However, the reverse is not true. If you already have a Medicare Supplement plan and you decide to change to Medicare Advantage, you’re allowed to keep your Medicare Supplement plan if you want to, even though it won’t help you pay for Medicare Advantage out-of-pocket expenses.
When can I change Medicare plan options from Medicare Advantage to Medicare Supplement?
To buy a Medicare Supplement plan, you must first leave your Medicare Advantage plan and return to Medicare, Part A (hospital insurance) and Part B (medical insurance) administered under the federal Medicare program. But here’s what you need to know about changing from Medicare Advantage to Medicare Supplement:
- You can only leave your Medicare Advantage plan during certain times of the year, in most cases: during the Medicare Advantage Disenrollment Period (January 1 – February 14), or during the Medicare Advantage and Prescription Drug Annual Election Period (October 15 – December 7). There are some exceptions, such as if you move from home to an institutional setting such as a nursing home, or from an institutional setting to home. Other exceptions are noted below.
- Once you’ve returned to Original Medicare, you can apply for a Medicare Supplement plan anytime you want – but your acceptance into a plan isn’t always guaranteed. For example, if you have health problems, the insurance company can base its decision on your health history in a process known as medical underwriting. The company can decide not to sell you a plan, or to charge you more because of your health condition.
When can I change to Medicare Supplement with guaranteed-issue rights?
In some cases you may be able to change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed-issue rights, meaning that the insurance company must accept you as a member and cannot charge you more due to your health condition. However, in some cases the company may be allowed to impose a waiting period on coverage relating to your health condition.
Here are some general circumstances under which you may generally change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed issue. This list might not include every situation that could give you guaranteed-issue rights. Please note that these situations generally have time limits; in most cases, you apply for the Medicare Supplement insurance policy within 63 calendar days after your Medicare Advantage coverage ends.
- You enrolled in a Medicare Advantage plan when you were first eligible for Medicare and you aren’t happy with the plan, which you’ve had for a year or less. You generally have a special right to purchase a Medicare Supplement plan if you return to Medicare Part A and Part B within 12 months of enrolling in the Medicare Advantage plan.
- You move to an area your Medicare Advantage plan does not serve.
- Your Medicare Advantage plan no longer serves the area where you live.
- Your plan no longer has a contract with Medicare.
You might not have your choice of any of the 10 standardized Medicare Supplement plans available in most states; your choice might be limited to certain Medicare Supplement plans.
How do I switch from a Medicare Advantage plan to a Medicare Supplement plan?
Before you make any Medicare plan changes, you may want to make sure the Medicare Supplement plan you desire (out of those that you’re allowed to buy) will be available in your area at a price you’re satisfied with. Then you can leave a Medicare Advantage plan (during an appropriate time period described above) in one of several ways, such as:
- Call the Medicare Advantage plan you wish to leave and ask for a disenrollment form.
- Call 1-800-MEDICARE (1-800-633-4227) to request that your disenrollment be processed over the phone. TTY users should call 1-877-486-2048. Medicare representatives are available 24 hours a day, seven days a week, all U.S. time zones.
- Call the Social Security Administration or visit your Social Security Office to file your disenrollment request.
You can call Social Security at 1-800-772-1213 (TTY users can call 1-800-325-0778). Representatives are available Monday through Friday, from 7AM to 7PM, all U.S. time zones.
Leaving the Medicare Advantage plan automatically returns you to Original Medicare, Part A and Part B. Keep in mind, however, that if the Medicare Advantage plan you left included prescription drug coverage, and you still want prescription drug coverage, you will need to enroll in a stand-alone Medicare Part D Prescription Drug plan. You can find plans where you live and information about their costs and coverage using the Compare Plans button on this page.” When you apply, you can request that your Part D prescription drug coverage begin on the same future date as your Medicare Supplement plan.
If you have other questions about your Medicare coverage and options, I can help you. There are several convenient ways to learn more about your Medicare coverage–
- Use the links below to request a time to speak with me on the phone or to request that I email you personalized information, or both.
- Use the Compare Plans buttons on this page if you’d like to browse available plans in your area.
- Have a question that needs to be answered soon? Medicare.com’s licensed insurance agents are available to assist you Monday through Friday, 8 AM to 8 PM ET. Simply call 1-844-847-2660, TTY users 711.
The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations or the Federal Medicare program.
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