Leaving Medicare Advantage during October 15–December 7 does not, by itself, guarantee you can buy a Medigap policy without health questions.
You can always return to Original Medicare during open enrollment. But a Medigap insurer can ask health questions and decline you unless you have a guaranteed-issue right. Find your situation in the table below, then apply from 60 days before your plan ends to 63 days after — and line up Part D at the same time.
| Your situation | Medigap without health questions? |
|---|---|
| Leaving by choice during open enrollment | HEALTH QUESTIONS LIKELY Not guaranteed |
| Plan leaving Medicare or your area, or its network changes a lot | FEDERAL RIGHT Yes — Plans A, B, C*, D, F*, G |
| First year in Medicare Advantage, joined when first eligible | TRIAL RIGHT Yes — any Medigap plan in your state* |
| Dropped Medigap to try Medicare Advantage (first time, under 1 year) | TRIAL RIGHT Yes — your old policy if still sold |
| Live in New York or Connecticut | STATE RIGHT MAY APPLY Yes — year-round state rule |
| Live in Rhode Island, no coverage gap over 90 days | STATE RIGHT MAY APPLY Yes — during open enrollment |
| Live in California, Massachusetts, or Minnesota (age 65–70) | STATE RIGHT MAY APPLY In certain cases — see State Rules |
→ Use the Medigap Rights Checker.
And the detail most guides skip: different rights unlock different plans.
Medigap Rights Checker
Answer five questions to see your tier, the plans you can buy, your dates, and a note for your state. Nothing you enter is saved or sent anywhere.
Use the last day your coverage is active. If you leave during open enrollment, that is usually December 31.
Usually “yes” if you turned 65 before 2020.
Your result
Can You Switch From Medicare Advantage to Medigap?
Yes, you can — but the insurer may ask health questions unless you have a guaranteed-issue right.
If you want to switch from Medicare Advantage to Medigap, there are two separate steps. First, you leave your plan and return to Original Medicare during an enrollment period that allows it. Second, you buy a Medigap policy under Medigap’s own rules. Open enrollment helps with the first step. It does not settle the second.
Medigap works only with Original Medicare. Insurers generally can’t sell you a policy while you’re in a Medicare Advantage plan, unless you’re switching back and your plan will end before the Medigap policy starts. You can apply before your plan ends and ask the policy to start when it does.
Choosing between plans is a different job. For that, see Medicare Advantage Plans: Costs, Benefits & Picks and How to Compare Medicare Advantage Plans. If a denied claim is part of why you’re leaving, these may help: How to File a Health Insurance Appeal and Denied by an Algorithm?
Why Open Enrollment Doesn’t Guarantee Medigap
Open enrollment controls when you can leave a Medicare Advantage plan; it doesn’t control whether a Medigap company must accept you.
From October 15 to December 7, you can change from a Medicare Advantage plan back to Original Medicare, with or without a drug plan. Changes take effect January 1. From January 1 to March 31, people already in a Medicare Advantage plan can make one change: switch plans or return to Original Medicare. That change takes effect the first of the month after the plan gets your request. Neither period creates a Medigap guarantee on its own.
Medigap has its own one-time window. Your Medigap Open Enrollment Period lasts six months and starts the first month you have Part B and are 65 or older. It doesn’t repeat each year. Outside it, and without a guaranteed-issue right, a company may charge more, offer fewer options, or deny you based on your health.
| Period | Dates | What it allows | Medigap guarantee? |
|---|---|---|---|
| Medicare Open Enrollment (Annual Enrollment) | Oct. 15–Dec. 7; changes start Jan. 1 | Leave Medicare Advantage for Original Medicare, switch plans, join a drug plan | HEALTH QUESTIONS LIKELY Not by itself (Rhode Island and Minnesota are exceptions) |
| Medicare Advantage Open Enrollment | Jan. 1–Mar. 31 | One change: switch Medicare Advantage plans or return to Original Medicare (add a drug plan) | HEALTH QUESTIONS LIKELY Not by itself |
| Medigap Open Enrollment Period | 6 months from the first month you have Part B and are 65 or older | Buy any Medigap policy sold in your state | Yes — one time only |
| Guaranteed-issue window | 60 days before to 63 days after certain coverage ends | Buy the plans your specific right allows | FEDERAL RIGHT or TRIAL RIGHT — yes |
For context, CMS’s September 28, 2026 release projects about 34 million people in Medicare Advantage plans in 2027. That figure comes from plan projections, which CMS says have tended to understate actual enrollment (CMS press release). A KFF analysis estimated that roughly nine in ten Medicare Advantage enrollees age 65 and older, about 22.4 million people as of 2022, lacked Medigap guaranteed-issue protection beyond the trial period (KFF).
Your Federal Guaranteed-Issue Rights
Federal law gives you a guaranteed-issue right in specific situations, and each right unlocks a different set of plans.
In these situations the insurer must sell you a policy, must cover your pre-existing conditions without a waiting period, and can’t charge you more because of your health. Medicare.gov also calls these “Medigap protections.” You only have the right if you switch to Original Medicare, not if you join another Medicare Advantage plan.
FEDERAL RIGHT
Your plan changes or breaks the rules. This applies if any of these is true:
- Your plan is leaving Medicare.
- Your plan stops giving care in your area.
- You move out of the plan’s service area.
- Your plan’s network has a significant change.
- You leave a plan because the company misled you or didn’t follow the rules.
What it unlocks: Medigap Plan A, B, C*, D, F*, or G sold by an insurer in your state.
TRIAL RIGHT
You joined Medicare Advantage when first eligible for Medicare Part A at 65, and within the first year you want Original Medicare.
What it unlocks: any Medigap policy sold by an insurer in your state.*
You dropped a Medigap policy to join Medicare Advantage for the first time, you’ve been in the plan under a year, and you want your old policy back.
What it unlocks: the same Medigap policy you had, if the same insurer still sells it. If not, Plan A, B, C*, D, F*, or G sold in your state.
*Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. If you were eligible before that date but hadn’t yet enrolled, you may still be able to buy them. People new to Medicare on or after January 1, 2020 have the right to buy Plan D or G instead, which give the same benefits except the Part B deductible.
If more than one situation fits you, you can choose the right that works best. Some older charts and insurer pages also list Plans K and L for these rights. The March 2026 federal guide does not, so ask your SHIP whether any insurer in your state would offer them to you.
| Right | Plans you can buy | Window |
|---|---|---|
| FEDERAL RIGHT Plan leaving Medicare, leaving your area, you move out of its area, network change, or misled you | A, B, C*, D, F*, G sold in your state | 60 days before coverage ends (if you choose to leave) through 63 days after. Your plan’s termination notice may set a date too. |
| TRIAL RIGHT First eligible at 65, joined Medicare Advantage, within 1 year | Any Medigap policy sold in your state* | 60 days before to 63 days after coverage ends |
| TRIAL RIGHT Dropped Medigap to join Medicare Advantage for the first time, under 1 year | Your old policy if the same insurer still sells it; otherwise A, B, C*, D, F*, G | 60 days before to 63 days after coverage ends |
| Medigap Open Enrollment Period (for comparison) | Any Medigap policy sold in your state | 6 months from the first month you have Part B and are 65 or older |
The 60-Day / 63-Day Window
You can apply as early as 60 days before your Medicare Advantage coverage ends and no later than 63 days after it ends.
- Day −60: earliest to apply
- Plan ends: your last day of Medicare Advantage coverage
- Day +63: last day to apply
Example: if your coverage ends December 31, 2026, your window runs from November 1, 2026 through March 4, 2027. The checker above does this math for you.
Medigap can’t start until your Medicare Advantage coverage ends. Ask the insurer to start the policy when your plan ends so you have no gap. Generally, a Medigap policy begins the first day of the month after you apply, so applying early helps.
If your plan is leaving Medicare and you don’t choose another Medicare Advantage plan during open enrollment, you’re automatically enrolled in Original Medicare. If you want Medigap, don’t wait for that to happen. Apply early.
Trial Rights: Your First Year in Medicare Advantage
A trial right lets you try Medicare Advantage once and still buy Medigap if you change your mind within the first year.
There are two versions. In the first, you joined Medicare Advantage (or a PACE program) when you were first eligible for Part A at 65. If you decide within a year to switch to Original Medicare, you can buy any Medigap policy sold in your state. In the second, you dropped a Medigap policy to join Medicare Advantage for the first time. If you leave within a year, you can buy back the same policy if the same insurer still sells it. If not, you can buy Plan A, B, C*, D, F*, or G.
Both use the same 60-days-before to 63-days-after window. Medicare.gov notes your rights may last an extra 12 months in certain circumstances, so contact your state insurance department if you’re close to the one-year mark.
TRIAL RIGHT
Your year starts when your Medicare Advantage coverage began. If you’re close to the one-year mark, call your SHIP now.
Your Plan Is Leaving for 2027: What to Do Now
If your plan is leaving Medicare or your area for 2027, you’ll usually get a Plan Non-Renewal Notice in the mail in October, and you have a federal Medigap right.
- Read the notice and write down your coverage end date. Keep the letter and the envelope.
- Decide your direction: another Medicare Advantage plan, or Original Medicare with Medigap and a drug plan. For the first, see our guide to comparing plans.
- If you choose Medigap, run the checker above and call your SHIP to confirm your right and your plan options.
- Apply for Medigap early. Ask for the policy to start when your plan ends.
- Line up Part D to start the same day. See Don’t Forget Part D.
- Don’t drop your current coverage until you’re approved in writing and your drug plan is lined up.
State Rules, Sorted by Type
Some states add their own protections, but most state rules help people who already have Medigap, not people leaving Medicare Advantage.
Federal rights are the floor. States can add more. We sort the state rules by what they do, because “guaranteed issue” means different things in different places. Sources are the NAIC chart (May 11, 2026) unless noted. Tap a state to open its note.
Birthday and anniversary rules
HEALTH QUESTIONS LIKELY for most people leaving Medicare Advantage.
These let people who already have Medigap switch policies during a yearly window. Active in 2026: California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia and Wyoming. New Mexico starts January 1, 2027. They generally do not apply to a move from Medicare Advantage to Medigap.
New Mexico (from January 1, 2027)
For at least 60 days beginning in the policyholder’s birthday month, a person with Medigap may switch to a plan of equal or lesser value and may change carriers (NAIC chart, May 11, 2026).
Missouri (anniversary rule)
Missouri’s rule is tied to your policy anniversary rather than your birthday. The NAIC chart cites regulation 20 CSR 400-3.650. It is for people who already have Medigap. Ask your SHIP for the current window.
Year-round rules
STATE RIGHT MAY APPLY
A few states require insurers to accept Medigap applicants all year. Details differ, so confirm with your SHIP or state insurance department.
New York
The Department of Financial Services says insurers must accept Medigap applications at any time, regardless of health. The NAIC chart notes continuous open enrollment and community rating since 1996.
Connecticut
Connecticut is widely described as a year-round Medigap state, and a 2026 KFF analysis counts it among the few states with continuous or annual guaranteed issue. Sources differ on details, so confirm with the Connecticut Insurance Department or CHOICES, the state’s SHIP, at 1-800-994-9422 (CHOICES).
Massachusetts
The NAIC chart reports continuous open enrollment and community rating for Medicare-eligible residents (except people under 65 who qualify only through end-stage renal disease). Massachusetts Medigap plans are standardized differently from other states. Confirm with SHINE, the state’s SHIP.
Open-enrollment (fall) rights
STATE RIGHT MAY APPLY
Two states give a guaranteed-issue window during the October 15–December 7 open enrollment.
Rhode Island
Under OHIC Bulletin 2025-05 (issued September 26, 2025), people enrolled in Medigap or Medicare Advantage, with no coverage gap longer than 90 days since their Medicare Initial Enrollment Period, get guaranteed issue for any Medigap policy an insurer currently sells in the state during open enrollment. Coverage is effective January 1 (OHIC Bulletin 2025-05).
Minnesota (ages 65–70)
A Minnesota law effective August 1, 2026 creates a one-time guaranteed-issue window for people ages 65 to 70 during fall open enrollment. Secondary sources describe a higher premium for people who use it. Rules and eligibility details vary by source, so confirm with Minnesota’s SHIP before relying on it (HealthInsurance.org summary; KFF).
Other state rules
STATE RIGHT MAY APPLY in California. Others: ask your SHIP.
California
California Insurance Code § 10192.12 lists guaranteed-issue situations for people in Medicare Advantage beyond the federal ones. They include a plan raising its premium by 15% or more, raising doctor, hospital or drug copays by 15% or more, reducing benefits, or ending its relationship with a provider who is treating you. The statute generally points to Medigap from the same insurer or its affiliates, and unaffiliated insurers are limited mostly to the Medicare Advantage annual election period. Read the current text and ask HICAP, California’s SHIP, whether it fits you.
Vermont is different
Vermont is not a year-round guaranteed-issue state like New York or Connecticut, and the NAIC chart shows no birthday rule there. Vermont studied one and didn’t adopt it. Federal rights apply.
Maine
The NAIC chart says Maine lets people switch to a plan of equal or lesser benefits at any time if they’ve had continuous coverage supplementing Medicare with no gap over 90 days. Ask your SHIP whether this applies to a move out of Medicare Advantage.
Washington
Washington allows Medigap-to-Medigap switches without a health questionnaire within plan groups. When you switch from another type of coverage, insurers may still require one (NAIC chart).
| Type | States | Helps Medicare Advantage → Medigap? |
|---|---|---|
| Birthday rule | CA, DE, ID, IL, IN, KY, LA, MD, NV, OK, OR, UT, VA, WV, WY; NM from Jan. 1, 2027 | Generally no. For people who already have Medigap. |
| Anniversary rule | Missouri | Generally no. For people who already have Medigap. |
| Year-round | New York, Connecticut, Massachusetts | Yes, subject to state details. Confirm with your SHIP. |
| Open-enrollment window | Rhode Island; Minnesota (ages 65–70) | Yes, if you meet the conditions. |
| Medicare Advantage–specific | California | Yes, in the listed situations. |
| Other | Maine, Washington | Unclear for Medicare Advantage exits. Ask your SHIP. |
Medigap Birthday Rule States: 2027 Table
Fifteen states have an active birthday rule in 2026 and New Mexico joins on January 1, 2027, which makes 16; these rules generally help people who already have Medigap, not people leaving Medicare Advantage.
| State | Window | Carrier change? | Plan limits | Source & date |
|---|---|---|---|---|
| California | 60 or more days starting on your birthday | Yes, same or different carrier | Equal or lesser benefits | NAIC, May 11, 2026; effective Jan. 1, 2020; Ins. Code § 10192.11 |
| Delaware | Starts 30 days before your birthday and runs at least 30 days after | Not stated on chart | Same or lesser benefits | NAIC, May 11, 2026; effective Jan. 1, 2026 |
| Idaho | 63 days from your birthday | Yes | Same or lower level of benefits | NAIC, May 11, 2026; effective Mar. 1, 2022 |
| Illinois | 45 days from your birthday; ages 65 to 75 | No. Current insurer or an affiliate | Same or lower level of benefits | NAIC, May 11, 2026; effective Jan. 1, 2022 |
| Indiana | Window not stated on chart | Yes, any insurer | Same plan letter | NAIC, May 11, 2026; effective Jan. 1, 2026 |
| Kentucky | Within 60 days of your birthday | Yes, a different insurer | Same plan letter | NAIC, May 11, 2026; effective Jan. 1, 2024 |
| Louisiana | 63 days from your birthday | No. Current insurer or affiliates | Equal or lesser benefits | NAIC, May 11, 2026; date not stated |
| Maryland | 30 days from your birthday | Not stated on chart | Equal or lesser benefits | NAIC, May 11, 2026; effective July 1, 2023 |
| Nevada | 60 days from the first day of your birth month | Yes | Same or lower level of benefits | NAIC, May 11, 2026; effective Jan. 1, 2022 |
| Oklahoma | 60 days from your birthday; no coverage gap | Not stated on chart | Equal or lesser benefits | NAIC, May 11, 2026; date not stated |
| Oregon | 30 days before through 30 days after your birthday | Yes | Same or lower level of benefits | NAIC, May 11, 2026; effective Jan. 1, 2013, amended Jan. 1, 2023 |
| Utah | 60-day annual window | No. Current insurer only | Equal or lesser benefits | NAIC, May 11, 2026; enacted 2025 |
| Virginia | Window not stated on chart | Yes, same or a different insurer | Same plan letter | NAIC, May 11, 2026; effective July 1, 2025 |
| West Virginia | 60 days starting with the first of your birthday month; every two years with continuous coverage | Mostly no. Same company or affiliate (any company if the lesser plan isn’t offered) | Same or lesser plan | NAIC, May 11, 2026; effective June 11, 2026 |
| Wyoming | Begins on your birthday and lasts 63 days | “Any available” plan per chart | Same or lesser benefits | NAIC, May 11, 2026; date not stated |
| New Mexico | At least 60 days beginning in your birthday month | Yes, may change carriers | Equal or lesser value | NAIC, May 11, 2026; starts Jan. 1, 2027 |
No Guaranteed-Issue Right? Your Options
Without a right, an insurer may ask health questions, charge more, or say no, but you still have choices.
Stay in Medicare Advantage or switch plans
You can compare other Medicare Advantage plans during open enrollment or, if you’re already in a plan, during January–March. See How to Compare Medicare Advantage Plans.
Return to Original Medicare without Medigap
This is allowed. Original Medicare generally has no yearly cap on what you pay, and you typically owe 20% coinsurance on many services, while most Medicare Advantage plans have a cap. For how deductibles and out-of-pocket costs work, see How Health Insurance Works.
Apply for Medigap with health questions
You can apply before your plan ends and ask for the policy to start when it does. The insurer decides whether to offer you a plan and at what price. Ask whether there’s a waiting period for pre-existing conditions. Medicare.gov says such a waiting period can be up to 6 months, and recent creditable coverage can shorten or remove it. Apply early: if you’re leaving during open enrollment, you’ll want the decision before the December 7 deadline to leave your plan.
Check your state’s rules
Run the checker and read the state rules. A state right may apply even when no federal right does.
Ask your SHIP before you drop anything
State Health Insurance Assistance Programs give free, unbiased counseling. Find yours at shiphelp.org.
HEALTH QUESTIONS LIKELY
If you have no right, don’t drop your current coverage until you’re approved and your drug plan is lined up.
Don’t Forget Part D
If your Medicare Advantage plan included drug coverage, leaving it ends that coverage, so you need a standalone Part D plan that starts the same day.
Medigap plans sold after 2005 don’t include drug coverage. You may owe a Part D late enrollment penalty if, at any time after your Initial Enrollment Period, you go 63 or more days in a row without Part D or other creditable drug coverage. Medicare.gov says the penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each full uncovered month, and you generally pay it as long as you have Part D. People who get Extra Help don’t pay it.
Open enrollment (October 15–December 7) lets you join a drug plan starting January 1. If you drop Medicare Advantage during January–March, you can add a standalone drug plan then. CMS projects the average standalone Part D premium will rise from $35.09 in 2026 to $36.00 in 2027 (CMS).
Documents and Scripts
Gather proof of your right before you apply, and use the scripts below when you call.
Documents to keep
- Plan Non-Renewal Notice (and the envelope)
- Disenrollment confirmation
- Proof of move, if you moved out of the service area
- Your Medicare Advantage enrollment date
- Prior Medigap policy and its termination letter, if you use a trial right
- Part D confirmation
Call scripts
SHIP call script
I'm leaving my Medicare Advantage plan on [date]. Do I have a federal or state guaranteed-issue right for Medigap in [state], which plans can I buy, and what proof do I need?
Insurer application script
I'm applying under my guaranteed-issue right because [reason]. Please confirm no health questions apply and the policy's start date.
Cover note for your application
Date: [date] To: [Insurer name], Medigap enrollment Re: Medigap application under a guaranteed-issue right I am applying for Medigap Plan [letter] under a guaranteed-issue right because [reason, for example: my Medicare Advantage plan is leaving my area]. My Medicare Advantage coverage ends on [date]. Please start my Medigap policy when that coverage ends. Enclosed proof: - [Plan Non-Renewal Notice dated ___] - [Disenrollment confirmation] - [Other documents] Please confirm in writing that no health questions or waiting periods apply, and tell me my start date. [Your name] [Your phone number]
What Medigap Will — and Won’t — Cost You
Medigap premiums vary by plan, insurer, where you live, and how the insurer sets prices.
You pay the Medigap premium in addition to your monthly Part B premium. Each policy is priced one of three ways. Community-rated policies charge generally the same premium regardless of age. Issue-age-rated policies base the premium on your age when you buy. Attained-age-rated policies rise as you get older. In most states, all plans with the same letter offer the same basic benefits, so price is the main difference. Massachusetts, Minnesota and Wisconsin standardize their plans differently.
Higher-income households pay extra on Part B and Part D premiums. See IRMAA 2026 Brackets. Medigap generally doesn’t cover long-term care, vision or dental care, hearing aids, glasses, or private-duty nursing. For long-term care, see Is Long-Term Care Insurance Worth It?
Ask insurers how they price the policy, whether premiums have risen recently, and what discounts apply. Your SHIP can often share a state rate guide.
FAQ
Can I switch from Medicare Advantage to Medigap?
Yes. You first return to Original Medicare during an enrollment period that allows it, then buy Medigap. Whether the insurer may ask health questions depends on your right.
Can I do it without health questions?
Only with a guaranteed-issue right or a state protection. Federal rights apply if your plan is leaving Medicare or your area, its network changes significantly, or you’re in a trial period. Some states add rights.
Does the October–December enrollment period guarantee Medigap?
No. It lets you leave your plan. Medigap follows separate rules. Rhode Island and Minnesota have state exceptions during that period.
Can a Medigap company deny me for a pre-existing condition?
Outside your Medigap Open Enrollment Period, without a guaranteed-issue right, an insurer may deny you, charge more, or add a waiting period. With a guaranteed-issue right, it must cover your pre-existing conditions without a waiting period.
What happens if my plan leaves my area in 2027?
You have a federal right to buy Plan A, B, C*, D, F* or G if you switch to Original Medicare. Apply between 60 days before and 63 days after your coverage ends. Keep your plan’s notice.
What happens if my plan leaves Medicare?
The same right applies. If you don’t choose another Medicare Advantage plan during open enrollment, you’re automatically enrolled in Original Medicare. Don’t wait for that if you want Medigap.
How long do I have to buy Medigap after my plan ends?
No more than 63 days after your Medicare Advantage coverage ends.
What do 60 days before and 63 days after mean?
You can apply as early as 60 days before your coverage ends and as late as 63 days after. If coverage ends December 31, 2026, that’s November 1, 2026 through March 4, 2027.
What is the Medicare Advantage trial right?
A right to try Medicare Advantage and still buy Medigap if you leave within the first year. It applies if you joined when first eligible at 65, or if you dropped a Medigap policy to join for the first time.
Which Medigap plans can I buy with a guaranteed-issue right?
It depends on the right. Plan leaving or network change: A, B, C*, D, F*, G. First-eligibility trial right: any plan sold in your state. Dropped-Medigap trial right: your old policy, or A, B, C*, D, F*, G.
Can I buy Plan F or Plan C?
Only if you were first eligible for Medicare before January 1, 2020. If you were eligible before that date but hadn’t enrolled, you may still be able to. Otherwise, Plans D and G are the same-benefit substitutes without the Part B deductible.
Does the birthday rule apply if I’m leaving Medicare Advantage?
Generally no. Birthday rules are for people who already have Medigap and want to switch policies.
Which states have a birthday rule in 2027?
California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia and Wyoming are active in 2026. New Mexico starts January 1, 2027. Missouri has an anniversary rule.
Can I get Medigap anytime in New York or Connecticut?
New York’s Department of Financial Services says insurers must accept applications anytime. Connecticut is widely described as year-round too; confirm with CHOICES or the Insurance Department. Vermont is not the same.
What’s Rhode Island’s open-enrollment rule?
With Medigap or Medicare Advantage coverage and no gap over 90 days since your Initial Enrollment Period, you get guaranteed issue during October 15–December 7, with coverage effective January 1.
Does California give extra rights to Medicare Advantage members?
Yes, in certain cases. Examples include a plan raising premiums or copays by 15% or more, or cutting benefits. Details are in Insurance Code § 10192.12. Ask HICAP.
What if my state has no special rule?
Federal rights still apply if you qualify. If you don’t, health questions are likely. Call your SHIP.
Can I go back to Original Medicare without Medigap?
Yes. You’ll typically owe 20% coinsurance on many services with no yearly cap, so compare costs first.
Do I need a separate Part D plan?
Yes, if you want drug coverage with Original Medicare. Medigap plans sold after 2005 don’t include it.
Will I have a gap in drug coverage?
Not if you enroll in a Part D plan that starts the day your Medicare Advantage coverage ends. A gap of 63 or more days in a row can lead to a late enrollment penalty.
What proof do I need for a guaranteed-issue right?
Letters, notices, emails or claim denials showing your coverage ended, plus the postmarked envelope. You may need to send copies with your application.
Who can help me for free?
Your State Health Insurance Assistance Program (shiphelp.org), 1-800-MEDICARE (1-800-633-4227), and your state insurance department (NAIC directory).
This article is general information, not insurance or legal advice. Medicare and state rules change. State data last verified . Last updated .

Daniel Hayes is the founder and sole researcher at AdvoraHQ. He covers U.S. personal finance, insurance, and consumer law — working directly from IRS publications, federal and state statutes, court opinions, and SEC filings rather than secondary summaries. His focus is the gap between what readers think they know and what the source documents actually say. Daniel is not a licensed attorney, CPA, or financial advisor; his articles are educational and not personalized advice. Reach him at Daniel.Hayes@advorahq.com.
