Medicare Advantage lets almost anyone enroll each fall with no health questions asked, and switching to a different Medicare Advantage plan works the same way. Medigap doesn't. Federal law guarantees you a Medigap policy without health questions for one six-month window, and in most states, that's the only time it's guaranteed.
That difference doesn't matter until you want to switch, and by then the window may already be closed. Here's what actually determines whether you can move from Medicare Advantage to Medigap, and what to check before this year's open enrollment closes on December 7.
Decision
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The One Guaranteed Window Medigap Actually Gives You
Your Medigap guaranteed-issue window opens the month you're 65 or older and enrolled in Medicare Part B, and it lasts six months. Any company selling Medigap in your state has to sell you a policy at its standard rate during that window, regardless of your health, with no waiting period for a pre-existing condition.
Once that window closes, the guarantee closes with it in most states. The timeline below shows exactly when it matters.
The Trial Right That Can Bring the Window Back
Two situations reopen guaranteed issue for up to 12 months. If you enroll in Medicare Advantage the first time you're eligible for Medicare and decide within a year that you want Original Medicare instead, you get a trial right. If you had a Medigap policy, dropped it to try Medicare Advantage for the first time, and want to switch back within a year, you get a trial right to the same policy, or one like it, if your former insurer still sells it.
Both versions apply to your first Medicare Advantage enrollment only. Trying a second Medicare Advantage plan later doesn't reopen a new 12-month clock.
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Timeline
Your Medigap enrollment window
Count from the month your Part B coverage actually starts, not your birthday.
Any Medigap insurer in your state must sell you a policy now, regardless of health.
You can buy or switch a Medigap policy with the same guarantee through month six.
In most states, insurers can now ask health questions unless a separate guaranteed-issue right applies.
Checklist
Protect your options before you enroll
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Checklist
Check this before you drop Medicare Advantage
Do this before you cancel anything.
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Timeline
Track both timelines
Check off each date as it passes.
You can leave Medicare Advantage for Original Medicare with no health questions on the Medicare Advantage side. Adding Medigap without underwriting still depends on your trial right and your state.
This is the date that actually restores guaranteed issue for Medigap. Count from your enrollment date, not the calendar year.
File your guaranteed-issue application inside this window or you lose the protection even if you otherwise qualified.
Save what you confirmed here so you have it before you call anyone.
What Happens Outside the Trial Right
Past your original six-month window and any trial right, most states let insurers medically underwrite a Medigap application. That can mean health questions, a higher premium, a waiting period for a pre-existing condition, or a denial.
A handful of states go further than federal law requires, with continuous or annual guaranteed-issue windows. Your state may be one of them, so check before you assume the worst case applies to you.
If your Medicare Advantage plan is the one leaving, not you, Your Medicare Advantage Plan Might Not Exist Next Year. Here's What to Check Before Insurers Pull Out covers the separate guaranteed-issue right that applies when the plan drops out from under you instead.
Put the Decision Dates on Your Calendar
Medicare's fall calendar and your own trial-right calendar run on two different clocks. Confirm both before you make a move.
Common questions
How long is Medigap's guaranteed-issue window?
Six months, starting the month you're 65 or older and enrolled in Medicare Part B. During that window, any company selling Medigap in your state must sell you a policy at its standard rate, regardless of your health.
What is the Medicare Advantage trial right?
If you enroll in Medicare Advantage the first time you're eligible for Medicare, or you drop a Medigap policy to try Medicare Advantage for the first time, you get up to 12 months to change your mind and switch back with guaranteed issue rights. It only applies to your first Medicare Advantage enrollment, not every plan you try afterward.
Can I switch from Medicare Advantage to Medigap after my trial right ends?
In most states, yes, but the insurer can ask health questions, charge you more, add a waiting period for a pre-existing condition, or decline you outright. A handful of states offer protections beyond the federal minimum, so check with your State Health Insurance Assistance Program before you decide.
Should I cancel Medicare Advantage before my Medigap policy is approved?
No. Wait until your new Medigap policy, and a standalone Part D plan if you need one, is actually approved and active before you drop Medicare Advantage.
