Medicare advisory · Licensed in 40+ states
Medicare help for people who already have a plan, and a problem with it.
Most Medicare agencies sell you a plan at 65 and disappear. We specialize in what happens after: a Medicare Advantage network that dropped your doctor, drug costs that jumped, a Medicare Supplement application blocked by underwriting, or a plan that wasn't what the agent said it was. Actuaries and licensed advisors, not a call center.
Which of these sounds like you?
Pick what fits and we'll route your review.
Free. No enrollment required. A licensed advisor replies within one business day.
Medicare Advantage vs. Medicare Supplement: the trade-off nobody explains at enrollment
Medicare Advantage plans are easy to get into and hard to get out of. Medicare Supplement (Medigap) plans are the opposite. Understanding that asymmetry is most of what it takes to make a good Medicare decision.
| What matters | Medicare Advantage (Part C) | Original Medicare + Medigap |
|---|---|---|
| Doctors and hospitals | Plan network; HMO or PPO rules, referrals, prior authorization | Any provider that accepts Medicare, nationwide |
| Monthly premium | Often $0 beyond Part B | Part B plus a Medigap premium ($100–$300+/mo, varies by state and age) |
| Out-of-pocket exposure | Copays up to the plan's annual maximum ($4,000–$9,000+) | Little to none with Plan G or Plan N after the Part B deductible |
| Drug coverage | Usually built in (MAPD) | Separate Part D plan |
| Can you be turned down? | No. Guaranteed acceptance during enrollment periods | Only guaranteed in your Medigap Open Enrollment window or a guaranteed-issue situation. Otherwise medically underwritten |
| Switching later | Annual Enrollment (Oct 15–Dec 7) or MA Open Enrollment (Jan 1–Mar 31) | Leaving MA is easy; getting a Medigap plan back depends on underwriting or a GI right |
Neither is "better." A healthy 66-year-old who stays in-network can do well on Medicare Advantage for years. The problem is the exit: by the time a plan stops working, many people can no longer pass Medigap underwriting. That is the case we get called about most, and it is the reason we start every review by mapping your guaranteed-issue rights.
Medicare Supplement guaranteed-issue rights: when a carrier must accept you
A guaranteed-issue (GI) right means a Medigap insurer has to sell you a plan, cannot charge you more for health conditions, and cannot impose a pre-existing condition waiting period. These windows are short, usually 63 days, and most people don't know they have one.
Federal law creates GI rights in a defined set of situations. Many states add more. We check every one before we talk about underwriting.
Federal guaranteed-issue situations
- Trial right, first-time Medicare Advantage. You joined an MA plan when you first became eligible at 65 and want to leave within the first 12 months.
- Trial right, dropped Medigap for MA. You left a Medigap plan for Medicare Advantage for the first time and want to return within 12 months.
- Your plan leaves. Your MA plan stops serving your area, leaves Medicare, or you move out of its service area.
- Employer or union coverage ends. Retiree or group coverage that supplemented Medicare is terminating.
- Your Medigap insurer fails or your coverage ends through no fault of your own.
- You were misled. You leave an MA or Medigap plan because the company or agent misrepresented it or broke the rules. This one requires documentation, and we help you build it.
State rules that add windows
- Birthday rules (states such as California, Oregon, Illinois, Idaho, Nevada, Kentucky, Louisiana, Maryland, Oklahoma): a yearly window around your birthday to switch Medigap plans without underwriting, usually to equal or lesser coverage.
- Continuous or annual open enrollment (states such as New York, Connecticut, Maine, Missouri): Medigap is guaranteed-issue year-round or annually on your policy anniversary.
- Under-65 and disability rules that require carriers to offer Medigap to people on Medicare through disability in certain states.
Declined for a Medicare Supplement? A decline from one carrier isn't a decline from all of them.
Medigap underwriting is not standardized. Each carrier writes its own health questions, its own look-back periods, and its own list of conditions it declines, rates up, or accepts. The same person can be declined by one company and approved at standard rates by another.
We keep current underwriting guides for the carriers we're appointed with and pre-screen you before an application is submitted. That matters: some carriers ask whether you've been declined elsewhere, so applying blindly can make the next application harder.
Request an underwriting pre-screenWhat we look at before you apply
- Diagnoses, dates, and whether treatment is ongoing or resolved: the look-back window differs by carrier
- Medications, since some carriers underwrite from a prescription database rather than your answers
- Height and weight limits, which vary more than people expect
- Pending procedures or referrals, which are an automatic decline at most carriers until completed
- Whether a GI right makes underwriting unnecessary altogether
What a Medicare plan review includes
Rights and timing
We identify every enrollment period and guaranteed-issue window open to you, including state-specific rules, and the deadline for each.
Real-cost comparison
Premium plus expected out-of-pocket for your doctors, hospital, and medication list, modeled by an actuary. Not a brochure comparison of copays.
A written recommendation
Which plan, why, and what it would cost to be wrong. You can enroll through us, take it elsewhere, or keep what you have if it's already right.
Request a Medicare plan review
Tell us what's going on. A licensed advisor reviews it and replies within one business day with your options and any deadlines that apply.
- Free, with no obligation to enroll
- Reviewed by an actuary or licensed advisor
- We won't sell or share your information
Prefer to talk now?
(773) 657-9140 — call or text
Mon–Fri 9am–6pm CT
Medicare questions we answer every week
Can I switch from Medicare Advantage to a Medicare Supplement?
Yes, but it has two parts. You can leave Medicare Advantage during the Annual Enrollment Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31). Getting a Medigap plan is separate: unless you have a guaranteed-issue right, the Medigap carrier can underwrite you and decline or rate up the policy. We check for GI rights first, then pre-screen underwriting so you don't leave your MA plan without a place to land.
What is a Medigap guaranteed-issue right?
A situation defined by federal or state law in which a Medicare Supplement insurer must sell you a policy without health questions, at standard rates, and without a pre-existing condition waiting period. Examples include leaving Medicare Advantage within 12 months of first joining, your plan leaving your area, losing employer coverage, and, in some states, a yearly birthday-rule window. Most GI windows last 63 days.
I was declined for a Medicare Supplement. Is that final?
No. Underwriting rules differ by carrier. A condition that one company declines, another may accept or accept with a higher rate. We review your health history against current carrier guidelines and identify which companies are likely to approve you before you apply again.
What if an agent misrepresented my Medicare Advantage plan?
If a plan or its agent misled you about coverage, network, or costs, you may have a guaranteed-issue right to a Medigap plan and grounds for a complaint with the plan and with Medicare. We help you document what was said, what the plan actually provides, and file appropriately.
Do you charge for Medicare advice?
No. Advice and plan reviews are free. If you enroll through us, the carrier pays a commission. Commissions on Medigap plans are broadly similar across carriers, so our recommendation isn't tied to which one pays more.
Are you connected with Medicare or the government?
No. Smart Insurance Agents LLC is an independent, licensed insurance agency. We are not affiliated with or endorsed by Medicare or any government agency. For information on all your options, contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP).