The Medicare Advantage trial period allows you to test the plan for a year. If you decide to switch, you can still purchase a Medigap plan during this time.
Medicare allows you to try Medicare Advantage without losing your access to Medigap. This is known as the Medicare Advantage trial period or the Medicare “right to try.”
During this time, you can buy a Medicare Advantage plan and keep it for up to 1 year.
If you leave the plan during that year, you can buy a Medigap plan without medical underwriting. You won’t have to worry about being denied a Medigap policy or charged a high rate.
You can also return to Original Medicare and, depending on which Medicare Advantage Plan you had, may be able to purchase a Medicare Part D prescription drug plan as well.
You have the right to a Medicare Advantage trial period. The trial period gives you 1 year to try a Medicare Advantage (Part C) plan and see if it’s right for you.
If you decide that it’s not, you can switch back to Original Medicare (parts A and B) and purchase a Medigap plan. Medigap is also known as Medicare supplement insurance.
Two different situations will allow you to have a trial period:
You enrolled in Medicare Advantage first
If you enroll in a Medicare Advantage plan when you’re first eligible for Medicare but leave the plan within 12 months, you can purchase any Medigap plan available in your area without medical underwriting.
Medical underwriting is a process by which insurance companies look at your health status when you apply and decide whether or not to approve coverage. Depending on your health, you can be denied a Medigap plan or charged a much higher premium.
Can you switch from Medicare Advantage to Medigap without underwriting?
When you first sign up for Medicare, there’s no medical underwriting for a Medigap policy. During your initial enrollment period, you can buy any plan in your area and can’t be charged higher rates for any health conditions you have.
After this initial enrollment ends, though, you can be denied a Medigap plan—unless you buy one after your Medicare Advantage trial period.
For example, let’s say you didn’t enroll in Medigap when you first became eligible for Medicare. Years later, you want to purchase a Medigap plan. If you’ve been diagnosed with congestive heart failure (CHF) or diabetes, for example, you might be denied a plan or offered only plans with very high premium rates.
However, let’s say you did choose to purchase a Medigap plan during your initial enrollment. You’d be guaranteed a policy and a good rate, and your diagnosis of CHF and diabetes wouldn’t disqualify you.
You enrolled in Medigap first
If you leave a Medigap plan within a year and enroll in a Medicare Advantage plan for the first time, this will trigger a special enrollment period. You can then buy your old Medigap plan again.
If your plan is no longer available, you can buy any Medigap A, B, C, D, F, G, K, or L plan in your area.
However, if you stay in your Medicare Advantage plan for 2 years and then try to switch back, you’ll have to wait for open enrollment. Plus, you might be denied the option to purchase your old plan — or any Medigap plan at all.
Note that your state may also provide additional exceptions under which you can get a Medigap plan if you don’t want to keep Medicare Advantage with 12 months of coverage.
The Medicare Advantage trial period doesn’t affect just Medicare Advantage (Part C). It allows you to switch your Medicare plan and put together the Medicare parts that work best for you.
It works with different parts of Medicare in slightly different ways:
- Medicare Parts A and B (Original Medicare): Medigap plans work with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), known together as Original Medicare. During the trial period, you’ll use Original Medicare when switching from Medicare Advantage. If you switch back to Original Medicare outside the trial period, you may not be guaranteed a Medigap policy.
- Medicare Part C (Medicare Advantage): The trial period exists to help you decide if a Medicare Advantage plan or a Medigap plan makes the most sense for you. You can switch to a Medicare Advantage plan during other open enrollment windows, but you won’t qualify for a trial period.
- Medicare Part D (prescription drug coverage): Many Medicare Advantage plans include Part D coverage. If the Medicare Advantage plan you had during your trial period was one of them, you can also get a stand-alone Part D plan now.
The trial period can impact your cost for a Medigap plan.
The cost of a Medigap plan is affected by factors like your:
- age
- gender
- overall health
When you use the trial period, you’re guaranteed a good rate, even if you wouldn’t normally qualify for one.
For example, if you used the trial period and switched away from your Medicare Advantage plan within your first year of enrollment, your rates for the exact same Medigap plan could be much cheaper than if you changed after 15 months.
All Medicare members are eligible for the Medicare Advantage trial period if they’re new to Medicare Advantage. You’ll also need to be either in your initial enrollment window or dropping a Medigap plan.
The Medicare Advantage trial period has no other time requirements.
If you left your Medigap plan to try a Medicare Advantage plan, you’d enter a trial period, whether you’d been enrolled in Medicare for 3 or 13-plus years.
Conversely, if you were enrolled in original Medicare but not a Medigap plan for 2 years and now want to switch from original Medicare to an Advantage plan and don’t qualify for a trial period, you would still be able to switch back to Original Medicare during open enrollment.
However, you wouldn’t be guaranteed the option to purchase a Medigap policy.
You don’t need to enroll for the Medicare Advantage trial period. You’ll be automatically enrolled as long as your Medicare Advantage enrollment is eligible for the trial period.
You can purchase a Medigap plan 63 days after leaving your Advantage plan. You can also purchase a plan starting 60 days before your Medicare Advantage plan coverage ends.
You don’t need to take any additional steps. You can cancel your Advantage plan and purchase a Medigap plan.
So, how do you decide between Medigap and Medicare Advantage?
The following chart summarizes key similarities and differences between Medicare Advantage and Medigap:
| Medigap | Medicare Advantage (MA) | |
|---|---|---|
| How it works | This fills in the gaps for Original Medicare (Parts A & B). | This replaces Original Medicare (Parts A & B). |
| Eligibility | You must be enrolled in Original Medicare and be over the age of 65. | You must be enrolled in Original Medicare, live in the plan’s service area, and be over the age if 65. |
| Availability and providers | Medicare providers are paid directly by Medicare, and Medigap covers the remaining expenses. You can choose any Medicare-accepting provider. | MA is billed directly. Depending on HMO vs PPO, your plan may cover only in-network providers and may require referrals for specialists. |
| Prescription Drugs | Does not include, so you’ll need Part D. | Some plans may include drug coverage, while others may require you to get Part D. |
| Cost and coverage | The plans are standardized in each state, which means the coverage is similar, but monthly premiums among options may differ. Your benefits won’t change with renewal. | The plans are not standardized; both the costs and the coverage vary. Your benefits change annually. |
Learn more: Medicare Advantage vs. Medigap (Medicare supplement)
The Medicare Advantage trial period allows you to try out Medicare Advantage and decide if it’s right for you. You’ll have a year to see if the plan works for you.
If it doesn’t, you can buy a Medigap plan without any medical underwriting or go back to Medigap if you had it previously. The trial period only applies when you first enroll in Medicare or leave a Medigap plan to enroll in a Medicare Advantage plan for the first time.