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Open Enrollment lets you leave a Medicare Advantage plan and return to Original Medicare for 2027. But many people who make that switch also want a Medigap policy to help with Original Medicare's out-of-pocket costs, and that's where it can get hard. A recent KFF analysis finds that 74 percent of Medicare Advantage enrollees, about 20.9 million people, had at least one health condition in 2023 that could get them turned down for a Medigap policy. Here's who's protected, who isn't, and what to check before December 7.
📋Quick Summary
- You can switch from Medicare Advantage to Original Medicare during Open Enrollment, October 15 to December 7.
- Outside certain protected times, there's no federal guarantee an insurer will sell you a Medigap policy, and it may cost more because of your health.
- 74 percent of Medicare Advantage enrollees, about 20.9 million people, had a condition in 2023 that could lead to a Medigap denial.
- You have a federal right to buy Medigap if your Medicare Advantage plan is ending or you're moving out of its coverage area, and in some cases if you joined Medicare Advantage within the past 12 months.
- Connecticut, Maine, Massachusetts and New York require insurers to offer Medigap to people 65 and older regardless of health, on a continuous or yearly basis.
Why Medigap Can Be Hard to Get After Medicare Advantage
According to Medicare.gov, your best chance to buy Medigap is your Medigap Open Enrollment Period, the six months that start the first day of the month you're 65 or older and signed up for Part B. After that, your options may be limited, a policy may cost more because of past or present health problems, and there's no federal guarantee an insurance company will sell you one.
KFF found that in 2023, 74 percent of Medicare Advantage enrollees, or 20.9 million people, had at least one condition that could lead to a Medigap denial, and the true share may be higher. The most common were peripheral vascular disease, chronic kidney disease, coronary artery disease, and diabetes with complications.
Original Medicare has no cap on out-of-pocket costs, which is why many people want Medigap to go with it. KFF reports Medigap premiums averaged $244 a month in 2025 among current policyholders.
Don't drop your Medicare Advantage plan until you know whether you can get Medigap. Medigap coverage can't start until your Medicare Advantage coverage ends, so ask a Medigap insurer how and when you can apply and what it would cost. A State Health Insurance Assistance Program (SHIP) counselor can also walk you through your options.
When You Have a Right to Buy Medigap
Federal law gives you a guaranteed right to buy Medigap in certain situations. If you have Medicare Advantage, these are the ones Medicare.gov describes:
- Your plan is leaving Medicare, will no longer cover where you live, or didn't follow the rules or misled you, or you're moving out of its coverage area. If you switch to Original Medicare you can buy Plan A, B, C, D, F, G, K or L sold in your state. If you were new to Medicare on or after January 1, 2020, you can buy Plans D and G instead of C and F.
- You joined a Medicare Advantage plan when you were first eligible for Medicare, and it's been less than a year. You can buy any Medigap policy sold in your state.
- You had a Medigap policy before you joined Medicare Advantage, you joined for the first time within the past 12 months, and you want to switch back. You can buy your old policy if the same insurer still sells it, or otherwise Plan A, B, C, D, F, G, K or L. The same note about Plans C, F, D and G applies.
For plan-ending situations, Medicare.gov says you only have this right if you switch to Original Medicare rather than joining another Medicare Advantage plan. It's also illegal for someone to sell you a Medigap policy while you have a Medicare Advantage plan. You can apply as early as 60 days before your Medicare Advantage coverage ends and no later than 63 days after it ends.
For the full list of situations, see our guide to Medigap guaranteed issue rights.
Related Medicare Updates
States With Extra Protection
KFF reports that Connecticut, Maine, Massachusetts and New York require insurers to offer Medigap to everyone 65 and older on a continuous or yearly basis, regardless of medical history. Some other states add rights in specific situations. Medicare.gov's answers cover only your federal rights, so contact your state to find out whether you have more options.
Where you live also affects how many people could be turned down. KFF found the share of Medicare Advantage enrollees with a condition that could lead to a denial in 2023 ranged from 82 percent in Florida to 59 percent in Alaska.
What to Check Before December 7
- See whether you have a guaranteed right. If your plan is ending, you're moving out of its coverage area, or you joined Medicare Advantage within the past 12 months under the conditions above, you may have one. If your plan is ending in 2027, see our guide to cancelled plans.
- If you don't have a guaranteed right, ask Medigap insurers whether they'd accept you and at what price before you drop your plan.
- Compare the full cost. If you switch to Original Medicare, you may need to join a separate drug plan. Add a Medigap premium and compare the total against your Medicare Advantage plan's costs. Drug plan premiums are changing for 2027, so check our plan-by-plan guide.
- Your State Health Insurance Assistance Program offers free, one-on-one counseling. Find your local program at shiphelp.org.
- Changes made by December 7 start January 1. If you're already in Medicare Advantage, you can also switch to Original Medicare from January 1 to March 31. Our key dates guide explains the rules.
For more, see Switching Into Medigap Is Getting Harder — and Some Seniors Are Being Denied Coverage.
✅What This Means For You
If your Medicare Advantage plan is ending or you're moving out of its coverage area: You likely have a guaranteed right to buy Medigap if you switch to Original Medicare. Apply within the window that runs from 60 days before to 63 days after your plan coverage ends.
If you joined Medicare Advantage within the past 12 months, either when you first became eligible or after giving up a Medigap policy: You may be able to switch back and buy Medigap without being turned down for your health.
If you've been in Medicare Advantage for years and have health conditions: A Medigap insurer may turn you down or charge more. Ask whether you'd be accepted and at what price, and compare other Medicare Advantage plans before you decide.
If you live in Connecticut, Maine, Massachusetts or New York: State rules require insurers to offer Medigap to people 65 and older regardless of medical history, on a continuous or yearly basis. Check your state's rules for details.
Sources
- Nearly Three-Quarters of Medicare Advantage Enrollees Could be Denied a Medigap Policy Due to a Pre-Existing Condition — KFF, Oct 13, 2026
- Lack of Medigap Option Could Keep Many in Medicare Advantage — Medicare Rights Center, Oct 15, 2026
- When can I buy a Medigap policy? — Medicare.gov, Undated, accessed Oct 26, 2026
- Open Enrollment — Medicare.gov, Undated, accessed Oct 26, 2026
- Get Medicare Help from Your Local SHIP Program — SHIP National Technical Assistance Center, Undated, accessed Oct 26, 2026
- Joining a plan — Medicare.gov, Undated, accessed Oct 26, 2026
Explore Further
Common questions about leaving Medicare Advantage for Medigap
- Can I switch from Medicare Advantage to Original Medicare for 2027?
- Yes. During Open Enrollment, October 15 to December 7, you can switch back to Original Medicare, and the change starts January 1. If you're in a Medicare Advantage plan, you can also switch from January 1 to March 31.
- Can a Medigap insurer turn me down because of my health?
- Outside your Medigap Open Enrollment Period and other protected situations, there's no federal guarantee that an insurer will sell you a policy, and it may cost more because of your health. Some states offer more protection.
- When do I have a guaranteed right to buy Medigap after Medicare Advantage?
- If your Medicare Advantage plan is leaving Medicare, will no longer cover where you live, or you're moving out of its coverage area, or if you joined Medicare Advantage within the past 12 months when you were first eligible or after giving up a Medigap policy, and you switch back to Original Medicare.
- Which states let you buy Medigap regardless of health?
- KFF names Connecticut, Maine, Massachusetts and New York, which require insurers to offer Medigap to people 65 and older on a continuous or yearly basis.
- Should I drop my Medicare Advantage plan before I'm approved for Medigap?
- Medigap coverage can't start until your Medicare Advantage coverage ends, so find out in advance whether an insurer would accept you and what it would cost, and ask your SHIP counselor how to time your change.
