Goodsurance

Enrollment & timing

KFF: Nine in Ten Medicare Advantage Enrollees Ages 65 and Older Have No Federal Guarantee They Can Buy Medigap if They Switch Back to Original Medicare

A KFF issue brief finds that medical underwriting rules block most Medicare Advantage enrollees from accessing Medigap supplemental coverage if they later want the broader provider access of original Medicare, a gap that grows more consequential as plan exits accelerate heading into 2027.

By the Goodsurance editorial teamAugust 3, 2026

Most people who enroll in Medicare have a protected window at the start, typically six months after turning 65 and enrolling in Part B, during which insurers must sell them a Medigap supplemental policy regardless of their health history. After that window closes, federal law in 46 states allows insurers to turn down applicants who have pre-existing conditions or charge them higher premiums based on health status.

A KFF issue brief published in February 2026 found that roughly 90 percent of Medicare Advantage enrollees ages 65 and older, representing approximately 22.4 million people, have no guaranteed right to buy Medigap outside that initial trial period under current federal rules. Only four states, Connecticut, Maine, Massachusetts, and New York, require insurers to sell Medigap policies on guaranteed-issue terms year-round or during at least one designated open period annually.

Most Medicare Advantage enrollees have no federal right to buy Medigap if they want to switch back to original Medicare. KFF explains the gap.

The finding carries added weight as Medicare Advantage plan exits accelerate ahead of the 2027 enrollment season. Beneficiaries who are involuntarily disenrolled from an MA plan and choose to return to original Medicare may discover that Medigap coverage, which pays most of the cost-sharing that original Medicare does not cover, is unavailable to them or priced out of reach due to health history.

KFF also noted that Medicare beneficiaries under age 65 who enrolled based on disability face even more limited Medigap protections in most states. Several states have enacted birthday rules or similar annual windows that offer partial relief, but the KFF researchers found the patchwork remains incomplete.

In plain words

When you first join Medicare at age 65, insurance companies must sell you a Medigap plan no matter what health problems you have. But this right only lasts for a short time. After that, if you join a Medicare Advantage plan and later want to switch back to regular Medicare, most states let insurers turn you down for Medigap because of past health problems. A health research group called KFF found that about 22.4 million Medicare Advantage members who are 65 or older face this risk. Only four states require insurers to sell Medigap to anyone who wants it. This matters more now because more Medicare Advantage plans are leaving markets, pushing people back toward regular Medicare when they may not be able to get Medigap coverage.

Understand the basics first

Source: KFF
Read at the source →

More news

Other stories on what is moving in Medicare.

Enrollment & timing

KFF: Nearly All of the 2.6 Million Medicare Advantage Members Who Lost Plans at Year-End 2025 Had at Least One Alternative in 2026

A KFF analysis found 98.9 percent of affected enrollees had a replacement plan available, though rural beneficiaries faced fewer choices and Vermont saw the sharpest disruption.

September 21, 2026

Enrollment & timing

Employers Moved 1.2 Million Retirees Out of Medicare Advantage Drug Plans in 2026, First Decline Since 2010

Employer-sponsored Medicare Advantage drug plan enrollment fell by 1.2 million people in 2026, the first year-over-year drop since 2010, as employers shifted retirees into standalone drug plans at the fastest rate in more than a decade.

September 20, 2026

Enrollment & timing

Refugees and Asylees With Medicare Will Lose Coverage by February 1, 2027 Under a 2025 Law

A 2025 federal law restricts Medicare eligibility to citizens and permanent residents, ending coverage for refugees, asylees, and people with Temporary Protected Status. Those currently enrolled will lose coverage no later than February 1, 2027, and Medicare Rights Center this week urged CMS to ease the transition.

September 18, 2026

Enrollment & timing

Non-Renewal Notices for Expiring 2027 Medicare Plans Must Arrive by October 2, Opening Special Enrollment Rights

Federal rules require Medicare Advantage and drug plans that will not be offered next year to mail members a written notice by October 2. That letter triggers a special enrollment period and, in some cases, a guaranteed right to purchase Medigap coverage without health screening.

September 14, 2026

Enrollment & timing

The 2027 Medicare and You Handbook Is Being Mailed This Month. Here Is What to Do When It Arrives.

CMS mails the official Medicare handbook to all Medicare households in late September each year, landing a few weeks before open enrollment opens October 15. The 2027 edition arrives at a moment when drug plan costs and Medicare Advantage choices are shifting noticeably.

September 9, 2026

Enrollment & timing

Non-Renewal Notices Are Arriving This Fall. Here Is What to Do if Your Medicare Advantage Plan Is Not Coming Back in 2027.

Hundreds of thousands of Medicare Advantage members are receiving letters saying their plans will end at year-close. Federal rules give affected beneficiaries clear options, but there is a deadline to act.

September 8, 2026