Medicare Open Enrollment Ends December 7 – Should You Switch to a Medigap Plan?

Medicare’s open enrollment period runs through December 7, so there’s still time to make sure you’ve got the right coverage for 2026. With recent changes in the private Medicare Advantage (MA) market — fewer plans and trimmed add-ons — it may be worth considering switching to Original Medicare with a Medicare Supplement. Just make sure you understand what you stand to gain, and what you might give up.

Why consider switching to Medigap.

Original Medicare (Part A and Part B) has its pros. Unlike Medicare Advantage, it is not limited to use of a specific provider network. You can get care at almost all hospitals and doctors’ offices in the United States, and you rarely need prior authorization for medical services or supplies.

However, also unlike MA plans, original Medicare does not limit how much you pay for care in a given year. This is where having a Medicare Supplement (Medigap) plan can be helpful. Medigap, offered by private insurance companies, helps cover deductibles, copayments and other out-of-pocket expenses.

“It reduces the risk of paying too much when the cost is high [of care] That rate is high, said Dr. William Solomon, founder of White Manna Capital and president of the Accreditation Council for Medical Affairs (ACMA).

It also makes annual health care costs more predictable. With Medicare Supplement plans, you pay a set monthly premium, and in exchange, the insurance company will cover a certain percentage — for example, 100% of your doctor’s Part B contributions — of your other out-of-pocket costs.

Although Medigap does not cover common MA benefits, such as vision or dental care, some plans will pay for emergency care while traveling abroad.

As a result, “the individuals who tend to get the most out of Medigap are those who want predictable health care expenses and do not want to be bound by network regulations.” said Clayton Edson, Founder and CEO of AZ Health Insurance Agents. “I meet a lot of retirees who love to travel or have to deal with some underlying conditions, or just need to know their budget is stable, and that’s what Medigap can provide.”

Medigap swaps

Medigap plans have drawbacks. For starters, the plan’s premiums are higher than those of an MA plan, and in addition to skipping additional benefits, Medigap doesn’t come with prescription drug coverage, so you’ll need to buy a separate Part D policy if you switch from an MA plan that provides you drug coverage.

Additionally, “the process of leaving Medicare Advantage for original Medicare and adding a Medigap plan requires some planning,” Eidson said.

This is because while you can switch from an MA plan to a Medicare Supplement plan during open enrollment, you must meet certain criteria to drop out of medical underwriting and avoid being denied coverage or being charged higher rates for pre-existing conditions.

The criteria includes enrolling during the six-month period that begins once you turn 65 and get Medicare Part B. But you’re also eligible for guaranteed-release Medigap if you join an MA plan for the first time, have had it for less than a year and want to go back to original Medicare, or if your insurance company cancels your MA plan.

“This year, with many Advantage plan companies leaving the markets, those who are not healthy enough to qualify for a Medigap plan are being given a security release period,” said Scott R. Maybor, Managing Director at Senior Benefits Boston. “This may be the only time they will qualify for a Medigap plan if they are not healthy.”

Compare costs and coverage

It’s fairly easy to compare one Medicare Supplement plan to another, since all 10 plan types (A through N) offer uniform benefits.

The big variables are the stated monthly premiums and available deductibles. For example, some insurance companies offer discounts for women, non-smokers, and couples, while others discount automatic payments or multiple policies. For reference, average Medigap premiums can range from $32 to $550 per month.

“The rule of thumb is to always compare Medigap carriers by plan letter, followed by price, and last but not least, the company’s pricing history,” Eidson said. “Plan C is Plan C no matter who sells it; the real question is how that company maintains its rates and how it treats policyholders.”

Choosing between Medigap and Medicare can be more difficult, but you can determine fit based on the following:

Consider Medigap if:

• Expect high or unpredictable health care costs.
• You travel frequently or need flexible networks.
• You are eligible for a guaranteed release plan.

Consider Medicare Advantage if:

• You want to save on monthly payments.
• You’re looking for combined benefits, including vision and teeth.
• You are unhealthy, but you do not qualify for coverage for the guaranteed issue.

How to evaluate and make change

If you’re considering a last-minute switch, follow these steps to choose the best Medicare plan for you.

• Review your Medicare Annual Notice of Change (ANOC) To make sure you’re aware of all important changes to your current plan’s pricing, provider network, prescription drug coverage, and additional benefits — and whether a change is warranted.
• Compare external expenses For any plans you have in mind. You can use the Medicare Plan Finder to determine your options. Look at all your premiums, deductibles, copayments, and coinsurance. Remember, Medicare and Medigap do not cover prescription drugs. If you want to switch from an MA plan that does this, you’ll need to purchase (and take the cost of) a standalone Part D policy.
• Evaluate your health condition. If you have a chronic illness or need frequent, expensive treatments, such as physical therapy, your deductibles, copayments, and coinsurance will likely increase — and your Medicare supplement premiums may ultimately be cheaper. For example, “I had a client tell me she didn’t want to pay $200 a month for supplements, but she pays an $800 copayment three or four times a year for a shot in her back,” Maibor said.
• Understand your Medigap eligibility. If you are unhealthy, but need to undergo medical underwriting, you may not qualify for a reasonable plan or premiums, and you may benefit more from choosing a new MA plan.
• Contact a licensed Medicare broker Or a State Health Insurance Assistance Program (SHIP) advisor if you’re having difficulty comparing plans and want outside help.
• Make all decisions by December 7, 2025. This is the last day for open enrollment in Medicare. Your new choices will take effect on January 1, 2026.