How to Switch From Medicare Advantage to Medigap (Step-by-Step)

Why People Switch From Medicare Advantage Back to Medigap

Medicare Advantage still works well for some retirees, but plan exits, narrowing networks, rising copays, and prior-authorization headaches push many enrollees to reconsider. For 2026, Milliman reports that benefit value across general-enrollment MA plans fell by more than 7%, the largest decline in at least a decade, while average medical deductibles jumped from $33 to $57 and supplemental benefits shrank. Switching back to Original Medicare paired with a Medigap policy gives you nationwide doctor access, predictable out-of-pocket costs, and no referral or network restrictions.

The catch is that Medicare Advantage and Medigap are governed by different enrollment rules. You can leave an MA plan during specific federal windows, but a Medigap insurer can still ask health questions and deny you unless you qualify for a guaranteed-issue right. Understanding both halves of the equation is the key to a successful switch. If you're still weighing the trade-offs, our Medigap vs Medicare Advantage comparison breaks down 2026 costs and coverage side by side.

The Two Enrollment Windows for Leaving Medicare Advantage

There are two federal windows each year when you can drop an MA plan and return to Original Medicare. A handful of Special Enrollment Periods (SEPs) also exist for events like moving, losing employer coverage, your plan's contract termination, or (new for 2026) relying on inaccurate provider directory information on Medicare's Plan Finder.

Medicare Advantage Open Enrollment Period (Jan 1 to Mar 31)

This window is only for people already enrolled in a Medicare Advantage plan. From January 1 through March 31, you can make one change: switch to a different MA plan, or drop MA entirely and return to Original Medicare with a standalone Part D drug plan. The change becomes effective the first day of the month after the plan receives your request, so a request filed in February takes effect March 1.

Annual Election Period (Oct 15 to Dec 7)

The fall Annual Election Period (also called AEP or the Annual Open Enrollment Period) is open to all Medicare beneficiaries. You can join, drop, or switch MA plans and pick a new Part D plan. Changes take effect January 1 of the following year, giving you several weeks to line up a Medigap policy before your MA coverage actually ends.

Comparing the two windows

Medigap Trial Rights: Your Guaranteed-Issue Lifeline

A "trial right" is a federal guarantee that lets specific people switch from Medicare Advantage to Medigap with no medical underwriting, no pre-existing condition waiting period, and no health-based price increase. There are two scenarios where this applies, and both run on a strict 12-month clock.

Trial Right #1: You joined MA when you first became Medicare-eligible

If you enrolled in a Medicare Advantage plan when you first became eligible for Medicare at age 65 instead of buying Medigap, you have 12 months from your MA effective date to change your mind. During that window, you can drop MA and buy any Medigap plan sold in your state from any carrier on a guaranteed-issue basis.

Trial Right #2: You dropped a Medigap policy to try Medicare Advantage

If you had Original Medicare with a Medigap policy and dropped it to try a Medicare Advantage plan for the first time, you have 12 months to return to Medigap. Your first option is to get your original policy back from the same insurer if it's still sold. If not, you can buy Plans A, B, C, D, F, G, K, or L on a guaranteed-issue basis (Plans C and F are only available if you became Medicare-eligible before January 1, 2020). For details on which letter plans are still open to new enrollees, see our Plan G coverage breakdown.

Medical Underwriting: The Real Risk Outside Trial Rights

If you don't qualify for a trial right or another guaranteed-issue event (such as your MA plan terminating its Medicare contract or you moving out of its service area), Medigap carriers in most states can use medical underwriting. That means they can ask detailed health questions, request medical records, and deny your application or charge a higher premium based on your health. Our guide to Medigap underwriting when leaving Medicare Advantage walks through the carrier-by-carrier differences.

What carriers typically ask

Underwriting questionnaires vary, but most include:

• Current diagnoses and chronic conditions (diabetes, heart disease, COPD, kidney disease, cancer)
• All prescription medications you take
• Hospitalizations, surgeries, or major procedures in the past 2-5 years
• Height, weight, and tobacco use
• Whether you use oxygen, a wheelchair, or need help with activities of daily living
• Pending tests, procedures, or specialist referrals

Conditions that often trigger an automatic denial

Knockout lists vary by carrier, so a condition that disqualifies you with one insurer might be acceptable to another. Working with a broker who shops multiple carriers can help. For a deeper look at how underwriting works during the initial enrollment window versus afterward, read our Medicare Supplement Open Enrollment guide.

States That Waive Medical Underwriting

A handful of states give beneficiaries more flexibility than federal rules require. If you live in one of these states, you may be able to switch from Medicare Advantage to Medigap without health questions even outside the federal trial-right windows. For the full state-by-state breakdown, see our Medicare Supplement plans by state guide.

Year-round or near year-round guaranteed-issue states

• Connecticut - Medigap is guaranteed-issue year-round for all Medicare enrollees
• New York - Guaranteed-issue year-round, same as Connecticut
• Maine - You can switch to a Medigap plan with equal or lesser benefits any time of year, plus each carrier must offer Plan A on a guaranteed-issue basis during one month a year
• Washington - Year-round guaranteed-issue switching between Medigap plans
• Massachusetts - A 2-month guaranteed-issue window every February and March

Birthday-rule states (2026)

Birthday-rule states let existing Medigap enrollees switch plans without underwriting during a window tied to their birthday. The 2026 list has expanded to roughly 16 states: California, Idaho, Illinois, Nevada, Oregon, Kentucky, Indiana, Wyoming, Delaware, Utah, Virginia, West Virginia, Louisiana, Maryland, and Oklahoma, with Delaware's rule newly effective January 1, 2026, and West Virginia's effective June 1, 2026. Window length and conditions vary widely. California uses 60 days after your birthday with any carrier, Indiana and Kentucky offer 60-day windows but only for the same plan letter, and Illinois (from 2026) restricts switches to the same insurer or affiliate. New Mexico has a birthday-rule scheduled for 2027, and Pennsylvania has proposed legislation but nothing in force.

Missouri also offers an "anniversary rule" allowing same-letter plan changes during a 60-day window around your policy anniversary, and Rhode Island has a one-month annual guaranteed-issue window set by each carrier.

Step-by-Step Checklist for Switching

Here's the sequence that minimizes risk and prevents a coverage gap.

1. Confirm your eligibility and goals

Make sure you have both Medicare Part A and Part B. The 2026 standard Part B premium is $202.90 per month with a $283 annual deductible, and the Part A inpatient deductible is $1,736 per benefit period. Decide which Medigap plan letter fits your needs. Most new enrollees in 2026 pick Plan G or Plan N, with Plan G being the most comprehensive option still open to new beneficiaries.

2. Apply for Medigap FIRST

Submit the Medigap application before you disenroll from your MA plan. If you qualify for a trial right or other guaranteed-issue event, attach documentation. If you're being underwritten, wait for written approval before taking the next step. Our Medicare Supplement underwriting guide explains what carriers check and how to improve your odds.

3. Choose a standalone Part D plan

Medigap doesn't include drug coverage, so you'll need a separate Part D prescription plan. Check that your medications are on the formulary and that your preferred pharmacies are in-network.

4. Disenroll from Medicare Advantage

Once your Medigap policy is approved, disenroll from MA by one of these methods:

• Enroll in a standalone Part D plan (this automatically disenrolls you from MAPD)
• Call 1-800-MEDICARE
• Submit a written disenrollment notice to your MA plan
• Use Medicare.gov's plan finder during AEP

5. Verify all coverage start dates

Confirm in writing:

• Your MA coverage end date
• Your Original Medicare effective date (should be the day after MA ends)
• Your Medigap policy start date
• Your Part D start date

Pros and Cons of Making the Switch

For a closer look at how monthly premiums stack up, our AARP Medicare Supplement review and Plan N guide walk through real 2026 pricing examples. Budget-conscious shoppers may also want to consider High-Deductible Plan G, which has a $2,950 deductible for 2026 but much lower premiums.

Frequently Asked Questions

Can I switch from Medicare Advantage to Medigap at any time?

You can apply for Medigap any time of year, but disenrolling from your Medicare Advantage plan is restricted to the MA Open Enrollment Period (Jan 1-Mar 31), the Annual Election Period (Oct 15-Dec 7), or a qualifying Special Enrollment Period. Whether the Medigap insurer must accept you depends on guaranteed-issue rights and your state's rules. In Connecticut, New York, Maine, and Washington, you can switch year-round without underwriting.

How long do I have to use my Medigap trial right?

You have 12 months from the start date of your Medicare Advantage plan to use a trial right. You must apply for Medigap no earlier than 60 days before your MA coverage ends and no later than 63 days after it ends. Missing that 63-day window forfeits the guaranteed-issue protection even if you're still inside the 12-month period.

What happens if I'm denied Medigap due to underwriting?

If you're denied, you can apply with another carrier since knockout conditions vary by insurer. If every carrier denies you, your options are to stay on Medicare Advantage, try again during your state's birthday or anniversary window if you qualify, or move to a state with year-round guaranteed issue. Always wait for Medigap approval before disenrolling from MA.

Will I have a gap in coverage during the switch?

Not if you time it correctly. Original Medicare picks up automatically the day after your MA plan ends, and your Medigap and Part D plans should start that same day if you scheduled them properly. Always confirm the effective dates in writing before disenrolling.

Do I need to enroll in Part D when switching to Medigap?

Yes, if you want prescription drug coverage. Medigap policies don't include drug benefits, and if you go without creditable drug coverage for more than 63 days, you'll face a permanent Part D late enrollment penalty. Enroll in a standalone Part D plan so it starts the same day your Medigap policy begins.