Medicare Annual Enrollment begins October 15, and many Florida seniors will soon compare their current Medicare Advantage coverage with their options for 2027. One question comes up repeatedly during this time of year:
“Can I leave Medicare Advantage and get a Medicare Supplement plan instead?”
The answer can be yes—but there is an important catch that Medicare beneficiaries sometimes discover too late.
Leaving a Medicare Advantage plan and qualifying for a Medicare Supplement, also called Medigap, are not always the same thing. In many situations, you may have the right to return to Original Medicare but not have a guaranteed federal right to purchase the Medigap policy you want.
For Medicare beneficiaries throughout Tampa Bay, Apollo Beach, Riverview, Brandon, Bradenton, Sarasota and Florida's Gulf Coast, understanding this distinction before making a coverage change can prevent an unpleasant surprise.
Medicare Annual Enrollment Is Not Medigap Open Enrollment
This is one of the most important Medicare distinctions to understand.
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year. During this period, beneficiaries can make certain changes involving Medicare Advantage and Medicare Part D coverage for the following year.
But this annual period does not automatically give everyone a guaranteed opportunity to buy any Medicare Supplement policy they want.
Your primary federal Medigap Open Enrollment Period is different.
Medicare explains that this is a six-month period beginning the first month you're 65 or older and enrolled in Medicare Part B. During this period, you generally have the right to buy any Medigap policy sold in your state that's available to you without being denied because of your health.
After that six-month period ends, the rules can change significantly.
Medical Underwriting May Matter Later
Outside your Medigap Open Enrollment Period or another guaranteed-issue situation, Medicare says an insurance company may be permitted to use medical underwriting.
That means the insurer may ask health questions when evaluating your application.
Depending on the circumstances, Medicare says that outside your protected enrollment period, fewer options may be available, the policy may cost more, or an insurer may be allowed to deny your application if you don't meet its underwriting requirements.
This is why someone considering a move from Medicare Advantage to Original Medicare plus Medigap should understand their Medigap eligibility before finalizing the change.
Simply assuming, “I'll drop my Medicare Advantage plan and pick up a Supplement afterward,” can create problems if the Medigap application isn't guaranteed.
There Are Important Exceptions
Not every beneficiary changing coverage has to go through medical underwriting.
Federal law provides guaranteed-issue rights in certain circumstances. When a guaranteed-issue right applies, the insurer must sell you certain Medigap coverage, must cover pre-existing health conditions, and cannot charge you more because of past or present health problems.
One especially important protection is known as a trial right.
Trial Right: You Tried Medicare Advantage for the First Time
Suppose you previously had Original Medicare and a Medigap policy, dropped that Medigap policy to join Medicare Advantage for the first time, and you've been in the Medicare Advantage plan for less than a year.
Medicare says you generally have a one-time, 12-month trial-right period that may allow you to return to Original Medicare and get your former Medigap policy back if the same insurance company still sells it.
If your previous policy is no longer available, other Medigap options may be available under the applicable guaranteed-issue rules.
You Joined Medicare Advantage When You First Became Eligible at 65
There's another trial right for certain new Medicare beneficiaries.
If you joined a Medicare Advantage plan when you were first eligible for Medicare Part A at age 65 and decide within the first year that you'd rather have Original Medicare, Medicare says you can purchase certain Medigap policies available in your state when you switch back.
These protections are valuable, but the exact circumstances and timing matter.
The 63-Day Deadline Can Be Important
Some guaranteed-issue situations have specific deadlines.
Depending on the qualifying circumstance, Medicare says beneficiaries may be able to apply for Medigap beginning 60 days before their existing coverage ends and generally no later than 63 days after that coverage ends.
Medicare also recommends keeping letters, notices, emails and other documentation showing why your coverage ended because you may need to provide proof that you qualify for a guaranteed-issue right.
This is another reason not to wait until the last minute to investigate a change.
Medicare Advantage and Medigap Work Very Differently
Understanding eligibility is only part of the decision.
Medicare Advantage and Original Medicare with Medigap are fundamentally different ways of receiving Medicare coverage.
Medicare Advantage plans provide Medicare-covered services through private insurers and may use provider networks and plan-specific cost sharing. Many also include prescription drug coverage and additional benefits.
With Original Medicare plus a Medigap policy, Original Medicare generally pays first for Medicare-covered services and the Medigap policy helps pay certain remaining Medicare cost-sharing expenses according to the standardized plan selected.
Modern Medigap policies generally do not include prescription drug coverage. Someone who wants prescription coverage typically needs to consider a separate Medicare Part D plan.
Neither approach is automatically better for every Florida senior.
The right fit can depend on your doctors, travel habits, prescriptions, budget, healthcare usage and personal preferences.
Don't Cancel Existing Coverage Too Early
This deserves special attention.
If you're considering moving from one type of Medicare coverage to another, don't assume everything is approved until you've confirmed it.
Likewise, someone who currently has Medigap and is thinking about dropping it should understand that getting the same policy—or sometimes any Medigap policy—back later may not be guaranteed.
Medicare specifically warns beneficiaries that if they drop Medigap to join Medicare Advantage, they may not be able to obtain their former policy again unless a trial right or another protection applies.
A coverage decision made today can therefore affect the options available to you later.
Frequently Asked Questions
Can I switch from Medicare Advantage to a Medicare Supplement during Annual Enrollment?
You may be able to leave Medicare Advantage for Original Medicare during an applicable enrollment period, but that does not automatically guarantee that you can purchase any Medigap policy you want. Your Medigap enrollment rights are determined separately.
Can a Medigap company ask health questions?
Outside your Medigap Open Enrollment Period or a guaranteed-issue situation, an insurer may be allowed to use medical underwriting.
What is the Medigap Open Enrollment Period?
Your federal Medigap Open Enrollment Period lasts six months and begins the first month you're 65 or older and enrolled in Medicare Part B.
What is a Medicare Advantage trial right?
Certain beneficiaries who try Medicare Advantage for the first time may have a limited opportunity to return to Original Medicare and purchase Medigap without ordinary medical underwriting. The protection generally involves the first 12 months and depends on the circumstances.
Does Medigap include prescription drug coverage?
Medigap policies sold after 2005 don't include prescription drug coverage. Beneficiaries who want drug coverage can consider a separate Part D plan.
Before You Make a Medicare Change in Florida
If you're considering moving between Medicare Advantage and Original Medicare with a Medicare Supplement, investigate both sides of the change before taking action.
Don't assume that being allowed to leave one type of coverage automatically guarantees acceptance into another.
For seniors in Tampa Bay, Apollo Beach, Riverview, Brandon, Bradenton, Sarasota and throughout Florida's Gulf Coast, My Local Coverage can help you understand the differences and review the options available based on your individual situation.
Visit My Local Coverage or call (813) 608-0986 for personalized help.
