Can You Go Back to Original Medicare from a Medicare Advantage Plan?
Medicare Part C plans, which are most commonly called Medicare Advantage plans, are increasingly popular. In 2023, enrollment in Medicare Advantage exceeded 50% for the first time. These plans are popular because they provide benefits that Original Medicare does not. Benefits like dental, vision, and hearing coverage, Medicare flex cards, premium givebacks, and more. Unfortunately, in large part due to aggressive and misleading advertising tactics, many people enroll in plans without understanding the drawbacks of Medicare Advantage plans.
The key drawbacks are:
Provider networks that limit the doctors you can see
Frequent prior authorization requests that cause delays in care and, sometimes, lack of coverage
Plan variability that causes confusion about which doctors, prescriptions, and benefits are covered by your plan
These drawbacks contribute to unwelcome surprises and Medicare Advantage nightmares. All of the issues among these plans and the broader Medicare Advantage market result in many people leaving their Medicare Advantage plans to switch back to Original Medicare.
If you’ve realized your Medicare Advantage plan isn’t as good as you thought or have had a poor experience with Medicare Advantage, you’re probably considering a switch back to Original Medicare. Luckily, switching back to Original Medicare is relatively easy. You just have to wait for Open Enrollment or be eligible for a Special Enrollment Period. Below, we’ll answer some frequent questions about switching back to Original Medicare from Medicare Advantage. If you’d rather talk to someone and get help switching back to Original Medicare, give us a call at (855) 900-2427.
Is there a penalty to switch from Medicare Advantage to Original Medicare?
There is no penalty for switching from Medicare Advantage to Original Medicare. And, if you decide you want to switch again, there’s also no penalty to switch from Original Medicare to Medicare Advantage. You can switch between the two types of coverage as many times as you want. You just need to make the switch during eligible enrollment periods.
*Note that it is not as easy to enroll in Medigap outside of the Medigap Open Enrollment Period and a handful of other guaranteed issue periods. Without guaranteed issue, you’ll likely have to go through medical underwriting to enroll in a Medigap plan—and insurance carriers can reject your application based on your answers.
How to switch from Medicare Advantage back to Original Medicare
All you need to do to switch back to Original Medicare is drop your Medicare Advantage plan. Once you disenroll from Medicare Advantage, you’ll automatically return to Original Medicare coverage. There are specific enrollment periods during which you’re able to drop your Medicare Advantage plan. We outline those in the following section.
When can you drop Medicare Advantage and switch to Original Medicare?
There are two standard enrollment periods in which you can switch back to Original Medicare. The first standard period is Medicare’s annual Open Enrollment Period. This annual enrollment period occurs every year from October 15th to December 7th. During this, you can switch between Medicare Advantage plans, switch from Original Medicare to a Medicare Advantage plan, or drop your Medicare Advantage plan and switch back to Original Medicare. You can also switch between or enroll in a Medicare Part D plan during this time.
The second standard period is the Medicare Advantage Open Enrollment Period. This enrollment period occurs every year from January 1st to March 31st. During this, you can switch to another Medicare Advantage plan or switch from Medicare Advantage back to Original Medicare. This period is most commonly used by people who enroll in a new Medicare Advantage plan during Medicare Open Enrollment and realize it doesn’t fit their needs during the first few months of the year.
There are also several Special Enrollment Periods that enable you to switch back to Original Medicare. Most of these Special Enrollment Periods are triggered by special circumstances and life events, like moving. Medicare Advantage plans also have a trial right. This means that, within one year of one of the following, you can switch from Medicare Advantage back to Original Medicare through a Special Enrollment Period:
Enrolling in a Medicare Advantage plan during your first year on Medicare
Leaving your Medigap plan for a Medicare Advantage plan
Get help choosing the best Medicare coverage for your unique needs
The average Medicare enrollee can choose between over 40 Medicare Advantage plans. Each Medicare Advantage plan has its own provider network, premium, deductible, and coinsurance amounts. Each plan also offers different benefits.
With Original Medicare and Medicare Supplement providing additional options, comparing all of your coverage options can feel overwhelming. And, unfortunately, you can’t change your coverage whenever you want or need to. Chapter exists to make Medicare simple and to ensure Medicare beneficiaries get the support they need to choose the best Medicare coverage for their needs. If you want to switch back to Original Medicare or explore your coverage options, give us a call at (855) 900-2427 or schedule a time to talk. We’re happy to answer all of your Medicare questions without obligation!