Can Your MA Client Switch to Medigap? What KFF's 74% Number Means for Agents
Every AEP, somebody on an MA plan says, "I want to go back to a supplement." Sometimes that's easy. A lot of the time it isn't, and the worst thing you can do is help them drop a plan before you know they can get the new one.
The number to know
Per KFF, nearly three-quarters of MA enrollees (74%, or 20.9 million people) had a pre-existing condition that could get them denied a Medigap policy outside a guaranteed issue window.
Read that as an agent: three out of four switchers need to be screened before you move anything.
Where access is guaranteed
Per KFF, only four states, Connecticut, Massachusetts, Maine and New York, guarantee Medigap to everyone 65+ year-round or annually. Everywhere else, outside a GI window, carriers can generally underwrite.
What it costs
Per KFF, the average Plan G premium was $194 a month in 2025, up 13% on average from 2024. Your client needs to see that number, adjusted for their age, area and carrier, next to their current MA costs before deciding.
The three questions to ask first
Is there a GI right? A plan termination or service area exit generally creates one. If your client got a termination notice, read it with them. (Our plan exits guide walks through this.)
Do they live in a guaranteed access state? If it's CT, MA, ME or NY, the conversation is different.
If neither, can they pass underwriting? Walk through the carrier's health questions before they leave the MA plan. Our Med Supp underwriting field guide covers how.
Watch the carrier menu, too
Options shift. For example, Wellabe stopped writing new Med Supp business in Indiana after Oct 18. Current policyholders keep their coverage. Tell existing clients they don't have to move, and know your remaining options before you quote switchers.
The bottom line
GI clients, move with confidence. Everyone else gets screened before they drop a plan. Done right, you protect the client and you protect your book.
Get the free State Playbooks
Medigap access depends heavily on where your client lives. Brock puts out tons of resources like these, and the State Playbooks are built to help you work state by state. Get the free State Playbooks.
FAQ
Can a Medicare Advantage enrollee switch to Medigap?
Yes, but outside a guaranteed issue window most states let carriers underwrite. Per KFF, 74% of MA enrollees have a condition that could lead to a denial.
Which states guarantee Medigap access year-round or annually?
Per KFF, Connecticut, Massachusetts, Maine and New York guarantee Medigap to everyone 65+ year-round or annually.
What does Plan G cost on average?
Per KFF, the average Plan G premium was $194 a month in 2025, up 13% from 2024.
Should my client drop their MA plan before applying for Medigap?
No. Confirm GI rights or underwriting approval first.
