Switching From Medicare Advantage to Medigap in Maryland: Timing and New 2026 Rights
Updated: Oct 5
If you are thinking about leaving Medicare Advantage for Original Medicare and Medigap, treat it as two separate decisions. You need a valid time to leave your Medicare Advantage plan, and you also need to know whether a Medigap company must accept your application. The Medicare Annual Open Enrollment Period, October 15 through December 7, gives you a chance to return to Original Medicare for January 1—but it does not automatically guarantee that you can buy any Medigap policy you want.
That distinction matters in Maryland, especially now. A state law that took effect July 1, 2026 added two guaranteed-issue situations for eligible Maryland residents. Those protections are helpful, but they do not turn every Medicare Advantage departure into an automatic Medigap approval.
The short answer
Yes, you can switch from Medicare Advantage to Original Medicare and apply for Medigap. Whether the Medigap insurer can ask health questions, charge more because of health, or decline the application depends on your enrollment window and whether you have a federal or Maryland guaranteed-issue right.
Medigap works only with Original Medicare. It cannot be used to pay Medicare Advantage copays, and a Medigap policy cannot begin until your Medicare Advantage coverage ends.
Before changing anything, answer these questions in order:
When am I allowed to leave Medicare Advantage?
Do I have a Medigap open-enrollment or guaranteed-issue right?
If not, will a Medigap insurer approve me through medical underwriting?
When will my Original Medicare, Medigap, and Part D coverage each begin?
When can you leave Medicare Advantage?
Annual Open Enrollment: October 15–December 7
During Medicare's Annual Open Enrollment Period, you can leave Medicare Advantage and return to Original Medicare. A change submitted by December 7 takes effect January 1 of the next year.
This is the familiar fall window, but it is only the Medicare plan-change window. It is not an annual Medigap open enrollment period.
Medicare Advantage Open Enrollment: January 1–March 31
If you are already enrolled in Medicare Advantage, you can make one change during the Medicare Advantage Open Enrollment Period. You may switch to another Medicare Advantage plan or return to Original Medicare. If you return to Original Medicare, you may also join a standalone Part D prescription drug plan. The change generally starts the first day of the month after the plan receives the request.
Special Enrollment Periods
Certain events create a Special Enrollment Period. Examples include moving outside your plan's service area, losing Medicaid, or having a plan end its Medicare contract. The event determines what you can change and how long you have, so use the dates in your official notice rather than assuming every special window is the same.
Leaving Medicare Advantage does not always guarantee Medigap
Your federal Medigap Open Enrollment Period lasts six months. It begins the first month you have Medicare Part B and are 65 or older. This is generally a one-time period, not a window that returns every fall.
Outside that period, an insurer may use medical underwriting unless you qualify for a guaranteed-issue right. That can mean health questions, fewer available options, a higher price, or a declined application.
Common federal protections include:
Your Medicare Advantage plan leaves Medicare, stops serving your area, or has another qualifying coverage change.
You joined Medicare Advantage when you were first eligible for Medicare at 65 and decide to return to Original Medicare within your first 12 months. This is commonly called a trial right.
You dropped a Medigap policy to join Medicare Advantage for the first time, then decide within 12 months that you want to return to Original Medicare and Medigap.
The current federal Medigap guide explains that the exact policy choices and application deadlines depend on the protection you are using. Some guaranteed-issue applications may be submitted before Medicare Advantage ends and generally no later than 63 days after the coverage ends. Keep your plan notices because the Medigap company may require proof.
Maryland added two Medigap protections in 2026
Starting July 1, 2026, Maryland created two additional guaranteed-issue periods. In these situations, an eligible applicant can buy certain Medigap coverage without being denied or charged more because of health history.
The first applies to some people who lose Medicaid after enrolling in Medicare Part B. To qualify, the person must have had Medicaid and Part B at the same time and remained on Medicaid for at least six months after enrolling in Part B. The Medigap application must be submitted within 63 days after the Medicaid termination or the notice of termination, whichever is later.
The second applies to people who became eligible for Medicare before January 1, 2020 and have a qualifying federal Special Enrollment Period. Maryland says an eligible person may apply for any Medigap policy that is open to new members within 63 days after the qualifying event.
These are specific protections, not a blanket right for every Maryland resident leaving Medicare Advantage. If you think one fits your situation, use the Maryland Insurance Administration's advisory and keep the notice that created your enrollment right.
What about Maryland's Medigap birthday rule?
Maryland's birthday rule is often misunderstood. It gives someone who already has a Maryland-issued Medigap policy a yearly opportunity, on their birthday and for the following 30 days, to move to a Medigap policy with equal or lesser benefits without medical underwriting.
It does not create a guaranteed path from Medicare Advantage into Medigap. A person currently in Medicare Advantage must look instead to the one-time Medigap Open Enrollment Period, a federal trial or guaranteed-issue right, Maryland's 2026 protections, or ordinary underwriting.
Coordinate Medigap and Part D before you disenroll
Medigap plans sold after 2005 do not include outpatient prescription drug coverage. If your Medicare Advantage plan includes drug coverage and you return to Original Medicare, you will usually need a separate Part D plan.
Medicare's current Medigap guide says you may apply for Medigap before Medicare Advantage ends as long as you are leaving the plan. Ask for the Medigap policy to begin when the Medicare Advantage coverage ends so you do not create an avoidable gap. Do not assume an application is approved until you have confirmation from the insurer.
Part D is a separate decision. Check that your medications are on the new plan's formulary, review pharmacy options, and confirm the effective date. Our guide to Medicare Part D costs explains the cost pieces you should compare.
A practical switching checklist
Use this list before submitting a disenrollment request:
Confirm the enrollment period or Special Enrollment Period that lets you leave Medicare Advantage.
Determine whether you are in your one-time Medigap Open Enrollment Period or have a documented guaranteed-issue right.
If underwriting applies, obtain a Medigap decision before giving up coverage you may not be able to restore.
Match the end date of Medicare Advantage with the start dates for Original Medicare, Medigap, and Part D.
Compare the same Medigap letter across companies. Standardized benefits are the same for the same letter, but premiums can differ.
Keep your Annual Notice of Change, termination letter, Medicaid notice, or other proof that supports a special right.
Check doctors under Original Medicare and prescriptions under the standalone Part D plan.
Remember that Medigap does not generally cover routine dental, vision, or hearing care.
If you are still deciding whether the coverage structure fits, start with our Medicare Advantage versus Medigap comparison for Maryland. The goal is not simply to leave one plan. It is to make sure the replacement pieces are approved, affordable, and scheduled to start together.
Frequently asked questions
Can a Medigap company deny me after I leave Medicare Advantage?
It may be allowed to deny the application if you are outside your Medigap Open Enrollment Period and do not have a federal or Maryland guaranteed-issue right. That is why it is safer to determine Medigap eligibility before completing a voluntary switch.
Does Medicare Annual Open Enrollment guarantee Medigap acceptance?
No. Annual Open Enrollment controls when you can change Medicare Advantage or Part D coverage. Medigap acceptance follows different federal and state rules.
Can I keep Medicare Advantage and add Medigap?
No. Medigap supplements Original Medicare. It does not work with Medicare Advantage, and it cannot pay a Medicare Advantage plan's copays or deductibles.
Will the Maryland birthday rule help me leave Medicare Advantage?
No. The birthday rule is for Maryland residents who already hold a Maryland-issued Medigap policy and want to switch to a policy with equal or lesser benefits during the birthday window.
Do I need Part D after switching to Original Medicare?
If you want outpatient prescription drug coverage and do not have other creditable drug coverage, you will generally need a standalone Part D plan. A modern Medigap policy does not include Part D coverage.
If you want help coordinating the dates and checking which Medigap rules apply to your situation, contact Forest Brook Financial before you submit the final plan change. A short review can help you see whether underwriting or a guaranteed-issue protection applies and keep the coverage pieces aligned.
Forest Brook Financial is not affiliated with or endorsed by Medicare or any government agency. Plan availability, premiums, underwriting, and eligibility vary by insurer, applicant, location, and enrollment rights.
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