Should You Switch from Medicare Advantage?
7 questions. For current MA enrollees wondering if Original Medicare + Medigap G would serve them better heading into the next plan year.
Is your plan requiring more prior authorizations than before?
Have your key doctors left your plan's network?
Is your health becoming more complex — more conditions, specialists, procedures?
If any of these resonate, this 7-question assessment will show you whether switching before AEP makes financial and health sense.
Not on MA yet? Use Medigap Versus™ instead →
Question 1 of 7
How long have you been on your current Medicare Advantage plan?
This affects your trial rights — within your first 12 months on MA, you can return to Original Medicare and get Medigap without medical underwriting.
Enrolled in the past 12 months — trial right may apply
Past trial rights window in most cases
Medical underwriting may apply for Medigap (varies by state)
Question 2 of 7
Have you noticed any of these changes in your current plan?
Select all that apply. These are the top signals we track when evaluating whether switching makes sense.
Harder to get equipment, specialist referrals, or procedures approved
Primary doctor, specialist, or hospital is no longer in-network
Plan premium went up, or copays/coinsurance raised for next year
Dental/vision allowance cut, OTC allowance dropped, etc.
Plan dropped from 4+ to 3.5 or lower in this year's ratings
Select this if you haven't noticed any of these changes
Question 3 of 7
How has your health changed in the past year or two?
Growing healthcare complexity raises the stakes for PA denials and surprise costs.
Roughly the same health conditions and care needs
New chronic condition, cancer diagnosis, heart disease, etc.
Seeing cardiologist, oncologist, neurologist, or other specialists more frequently
Had or expecting inpatient stays, surgeries, or complex procedures
Question 4 of 7
Has your personal situation changed?
Travel and geographic changes severely limit MA plan coverage. Medigap follows you anywhere in the US.
Living in the same area, same lifestyle
Spending 3+ months in another state or traveling frequently
Planning relocation — your MA plan won't transfer with you
Question 5 of 7
How important is the freedom to see any doctor without network restrictions?
With Original Medicare + Medigap, you can see any doctor in the US who accepts Medicare — no referrals, no network limits, no authorization needed to see a specialist.
Second opinions at top institutions, specialist freedom, no referrals
I like flexibility but could manage with a broad PPO network
Happy with my current network, don't need nationwide access
Question 6 of 7
What is your current plan's Maximum Out-of-Pocket (MOOP) limit?
This is the most you'd pay in a single plan year before your MA plan covers 100% of covered services. With Medigap G, your only OOP risk is the $257 Part B deductible — every year.
Relatively protective MOOP for an MA plan
Near industry average — one serious event away from full exposure
High exposure — a hospitalization could reach this
Maximum exposure — Medigap G likely cheaper in a bad-health year
Question 7 of 7
Have you had a prior authorization denied in the past year?
PA denials for equipment, procedures, or specialist visits are the #1 reason beneficiaries consider switching to Medigap, which has no private insurer PA layer.
I was denied care or equipment that Medicare should cover
Got it approved but the process was time-consuming and stressful
Approvals have been straightforward this year
Haven't needed prior authorization this year
Cost Comparison: MA vs. Original Medicare + Medigap G
National 2026 averages. Your actual costs depend on plan and location.
| Factor | 🏥 Your MA Plan | 🛡️ OM + Medigap G |
|---|---|---|
| Monthly Premium | ~$395/mo (Part B + Plan G + Part D) | |
| Max Out-of-Pocket Risk | ✓ Best$257/year only | |
| Prior Authorization | Required for most services | ✓ BestNo private insurer PA layer |
| Doctor Choice | ✓ BestAny Medicare provider, nationwide | |
| Travel Coverage | ✓ BestFull coverage anywhere in USA | |
| Dental / Vision | ✓ BestUsually bundled | Not included — buy separately |
Your Next Steps
Annual Enrollment Period: Oct 15 – Dec 7
This is your primary window to switch from MA to Original Medicare. Changes take effect Jan 1. Don't wait until the last week — Medigap applications need processing time.