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En español | Medigap insurance works only with coverage from the original Medicare program. It covers some or most of your out-of-pocket costs (deductibles and copays) in the original program, depending on the policy you buy. But it doesn’t cover any out-of-pocket expenses in a Medicare Advantage plan.
This is a major consideration if you have a Medigap policy and you’re thinking of switching from original Medicare to a Medicare Advantage plan, because once you give up a Medigap policy you may not be able to get it back on the same terms.
However, there are some circumstances in which — if you drop out of Medicare Advantage and switch to original Medicare — you have the right to buy a Medigap policy with full protections under federal or state law (also known as “guaranteed issue”), which means that during certain time frames insurance companies cannot refuse to sell you a Medigap policy or charge higher premiums based on your health status or preexisting medical conditions. These circumstances include:
Note that these rights apply only to Medicare beneficiaries who are age 65 and over. They do not apply if you are younger and have Medicare on the basis of disability, unless you receive similar protections under the laws of your state.
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