What Is the Medicare Advantage Trial Period?

The decision to change your health insurance can be a tough one. You have to consider factors like the cost of monthly premiums, how well the coverage will meet your needs, and whether a plan’s network includes your preferred providers and pharmacy. If you’re thinking of switching from Original Medicare to a Medicare Advantage plan, get in touch with a licensed insurance agent for guidance on the options available in your area.  

While you’re examining those choices, you may find some peace of mind by learning about the Medicare Advantage trial period. This is your opportunity to try out Medicare Advantage coverage for the first time while avoiding one of the possible drawbacks if you end up deciding that you prefer Original Medicare.  

In this article, we’ll explain how a trial period could help you discover what type of insurance is the best choice for you. 

Why People Switch to Medicare Advantage … and Sometimes Switch Back 

Original Medicare is the health insurance provided through the federal government, mainly for people over 65, which consists of Medicare Parts A (hospital insurance) and B (medical insurance). If you’re on Original Medicare, you need to enroll separately in a Medicare Part D plan for prescription drug coverage. In addition, you’ll likely want to purchase a Medicare Supplement plan, also called Medigap, to help with some of the expenses that Medicare doesn’t cover, such as coinsurance and deductibles. 

As an alternative, you can enroll in a Medicare Advantage plan, also known as Medicare Part C, from a private insurance carrier. These plans substitute for Parts A and B, usually include Part D prescription drug coverage, and may offer other supplemental benefits, like dental, hearing, and vision. Combining those features can help you save on insurance costs. 

Depending on where you live and your situation, you may have a wide range of Medicare Advantage coverage options available to you; as of 2023, KFF estimated that the average Medicare beneficiary had access to 43 different plans. To take full advantage of your benefits, though, most plans require enrollees to see healthcare providers and use pharmacies that are part of their provider network. 

You’re free to make a variety of changes to your Medicare coverage, including moving from one Medicare Advantage plan to another or returning to Original Medicare, during the Annual Enrollment Period between October 15 and December 7 or when you qualify for a Special Enrollment Period. However, signing up for Medigap can be a little more complicated. 

Medigap and Guaranteed Issue Rights 

Most people become eligible for Medicare during their Initial Enrollment Period, which includes the three months before and after the month when you turn 65. At this time, you can enroll in Original Medicare. You may choose to add a Medicare Part D plan or to change to a Medicare Advantage plan.   

After you’ve turned 65 and enrolled in Medicare Parts A and B, you enter a six-month open enrollment window for Medigap. At this time, you can purchase any Medigap plan at preferred rates — the lowest possible price — without answering questions about your health. Under federal law, you have guaranteed issue rights, which means you can’t be denied or charged more for Medicare Supplement insurance because of any preexisting medical conditions. 

If you decide to switch to a Medicare Advantage plan during your Initial Enrollment Period, you’ll still have your guaranteed issue rights for the first 12 months. As long as you switch back to Original Medicare within that first year, you’ll still have the option to purchase a Medigap plan without answering medical questions. These rights last from 60 days before your Medicare Advantage plan coverage ends until 63 days afterward. 

After the first year, the situation changes, and enrollees often go through medical underwriting to start Medigap or change plans. Depending on your health needs, you may need to pay more or even be denied coverage altogether. 

There are exceptions to these underwriting requirements. In some states, you have annual opportunities to change Medigap plans without medical underwriting, and four states require insurance carriers to offer policies to people over 65. 

The Medicare Advantage trial period is one time when Medicare enrollees across the country have guaranteed issue rights for Medigap plans. 

How the Medicare Advantage Trial Period Works 

The trial period gives you the flexibility to try a Medicare Advantage plan for the first time while keeping your options open. Federal law maintains your Medigap guaranteed issue rights during this period, taking away some of the worries about whether you’ll be able to purchase supplemental insurance if it turns out that Original Medicare is the better choice for you.  

You activate this trial period when you leave a Medigap plan to start a Medicare Advantage plan for the first time. If you give up your current Medigap plan to enroll in Medicare Advantage, but decide to go back within 12 months, your insurance carrier is required to let you purchase the same policy without considering your medical conditions when determining the plan premium. If that policy is not available, you have guaranteed issue rights for another Medigap plan. 

Finding the Medicare coverage that matches your healthcare and financial needs can be complicated. The Medicare Advantage trial period lowers the stakes when you explore the possibilities that are out there. Even if you don’t find the ideal plan on your first attempt, you can have confidence that you’ll still be able to purchase supplemental insurance for the next year. 

About GoHealth 

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.