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Can I switch from a Medicare Advantage Plan to Original Medicare & Supplement Plan during Open Enrollment?

 

This is a question that comes up a lot at this time of year. In general, you can make any changes you would like during Fall Open Enrollment. You can switch from Original Medicare to a Medicare Advantage Plan, enroll in a new Part D plan, change your Medicare Advantage Plan, or switch from a Medicare Advantage Plan to Original Medicare.

 

However, it is important to keep in mind that depending on where you live, you may be limited in your ability to buy a Medigap policy. This is because, while the federal government sets general guidelines for Medigap enrollment, states can have additional rules. Some states also choose to be more flexible than the federal government in terms of who can buy a Medigap and when.

 

Under federal rules, there are only certain protected times when an insurance company is required to sell you a Medigap policy. During these times, the insurance company must offer you the best possible rate, regardless of your health status.

  1. During your Open Enrollment Period. The Medigap Open Enrollment Period spans for six months starting with the first month you are enrolled in part B. What this means is that after your Open Enrollment Period ends, you may not be able to buy a Medigap, or you may have to pay more because of health conditions. This is important to point out, as people signing up for Medicare for the first time may have to make a decision that will last their entire lifetime. In some cases, an individual who does not buy a Medigap during their Open Enrollment Period may not be able to buy one in the future.

  2. While you have a guaranteed issue right. If you do not enroll in a Medigap during your Open Enrollment Period, or you later disenroll, certain events can trigger a guaranteed issue right. During this time, you also have protections to buy a Medigap policy, and insurance companies cannot deny you coverage based on your health status. For example, if you are age 65 or older, you have a guaranteed issue right within 63 days of when you lose or end certain kinds of health coverage. This coverage change could occur if you had group health insurance that paid after Medicare, and you lost it through no fault of your own. When you have a guaranteed issue right, companies must sell you a policy at the best available rate, regardless of your health status, and cannot refuse to sell you a policy.

You may run into problems if you try to buy a Medigap policy outside of your protected enrollment periods. Companies can refuse to sell you a policy or may only let you buy one if you meet certain medical requirements. If an insurance company does agree to sell you a policy, you will probably need to pay a higher monthly premium, and you may need to wait six months before the Medigap will cover pre-existing conditions.

 

If you have any questions, please call 770-945-5261

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