Written By

Greg Wohl

Licensed Medicare Specialist

Many Florida Medicare beneficiaries enroll in a Medicare Advantage plan and later decide it is not the right fit. The network may be too restrictive, the plan may be leaving their county, or they may want the flexibility of Original Medicare when traveling or seeking specialist care.

The good news is that switching back to Original Medicare is possible. The critical issue is whether you can also get a Medigap supplement plan when you make the switch, because Original Medicare without Medigap leaves you exposed to significant out-of-pocket costs.

This guide explains the three enrollment windows for switching back, the Medigap guaranteed issue rights that apply in each window, and the specific rules that apply to Florida beneficiaries.

Key Takeaways

You can switch back during two main annual windows: The Annual Enrollment Period (Oct 15 to Dec 7) and the Medicare Advantage Open Enrollment Period (Jan 1 to Mar 31) both allow you to drop your Medicare Advantage plan and return to Original Medicare.
The Medigap guaranteed issue right is the critical factor: When you return to Original Medicare, you will likely want a Medigap supplement to cover the 20% coinsurance and other cost-sharing. In Florida, Medigap insurers can use medical underwriting outside of guaranteed issue periods, which can result in higher premiums or denial.
Your first year in Medicare Advantage is the safest time to switch back: If you enrolled in Medicare Advantage for the first time and want to switch back within 12 months, you have a guaranteed issue right to buy Medigap Plans A, B, C, F, K, or L from any insurer in Florida.
Plan exits trigger a guaranteed issue right: If your Medicare Advantage plan is leaving your service area or losing its Medicare contract, you have a guaranteed issue right to buy certain Medigap plans regardless of your health status.
Part D coverage must be arranged separately when returning to Original Medicare: Original Medicare does not include prescription drug coverage. When you drop your Medicare Advantage plan, you must enroll in a standalone Part D plan or face a late enrollment penalty if you go without creditable coverage.
Florida does not have year-round Medigap guaranteed issue: Some states require Medigap insurers to accept all applicants year-round. Florida does not have this requirement. Outside of specific guaranteed issue periods, you can be denied or charged more based on your health history.

The Three Windows for Switching Back to Original Medicare

There are three main situations in which you can drop your Medicare Advantage plan and return to Original Medicare. Each has different implications for your ability to get Medigap coverage.

1. Annual Enrollment Period (AEP): October 15 to December 7

During AEP, you can drop your Medicare Advantage plan and return to Original Medicare, effective January 1 of the following year. This is the most commonly used window. However, AEP does not automatically give you a guaranteed issue right for Medigap. You will need to apply for Medigap coverage and may face medical underwriting in Florida.

2. Medicare Advantage Open Enrollment Period (MA OEP): January 1 to March 31

If you are already enrolled in a Medicare Advantage plan, you can use the MA OEP to switch to a different Medicare Advantage plan or to drop your plan and return to Original Medicare. Changes made during MA OEP take effect the first day of the following month. Like AEP, this window does not automatically trigger a Medigap guaranteed issue right.

3. Special Enrollment Periods (SEPs)

Certain life events trigger an SEP that allows you to leave Medicare Advantage outside of the standard windows. SEP-triggering events include your plan leaving your service area, your plan losing its Medicare contract, you moving out of the plan's service area, and qualifying for Extra Help or Medicaid. Some SEPs do come with guaranteed issue rights for Medigap.

The Medigap Problem: Why Timing Matters So Much

Original Medicare (Parts A and B) covers 80% of most medical costs after your deductible. The remaining 20% coinsurance has no annual cap. A serious illness or hospitalization can result in thousands of dollars in out-of-pocket costs under Original Medicare alone.

Most people who return to Original Medicare want to add a Medigap supplement plan to cap their costs. The problem is that in Florida, Medigap insurers can use medical underwriting outside of guaranteed issue periods. If you have pre-existing conditions, you may be charged a higher premium or denied coverage entirely.

When you DO have a guaranteed issue right for Medigap:

Within the first 12 months of your first Medicare Advantage enrollment (trial right)
When your Medicare Advantage plan is discontinued or leaves your service area
When you lose employer or union coverage that supplemented Medicare Advantage
When you move out of your plan's service area

When you do NOT have a guaranteed issue right: If you switch back to Original Medicare during AEP or MA OEP without a qualifying event, you do not have a guaranteed issue right in Florida. You must apply for Medigap and may face underwriting.

For a full overview of Medigap plan options and how to choose between them, see our Medicare Supplement insurance guide.

The Trial Right: Your Safest Window to Switch Back

If you enrolled in Medicare Advantage for the first time and have been in the plan for less than 12 months, you have what Medicare calls a trial right. This is the most favorable window for switching back to Original Medicare.

What the trial right gives you: You can return to Original Medicare and buy Medigap Plans A, B, C, F, K, or L from any insurer in Florida without medical underwriting. The insurer cannot deny you coverage or charge you more based on your health status.

Important limitation: The trial right only applies to your first enrollment in Medicare Advantage. If you have previously been enrolled in Medicare Advantage and switched back before, the trial right does not apply again.

How to use the trial right: Contact your Medicare Advantage plan to disenroll, then contact Medicare (1-800-MEDICARE) or your State Health Insurance Assistance Program (SHIP) to confirm your return to Original Medicare. Then apply for Medigap coverage within the guaranteed issue window.

For help comparing your Medigap options before making the switch, schedule a free consultation with our licensed specialists.

What Happens to Your Part D Coverage When You Switch Back

Most Medicare Advantage plans include prescription drug coverage (MAPD plans). When you drop your Medicare Advantage plan and return to Original Medicare, you lose that drug coverage.

You must enroll in a standalone Part D plan to maintain prescription drug coverage. If you go without creditable drug coverage for 63 or more consecutive days, you will face a late enrollment penalty when you eventually enroll in Part D. This penalty is permanent.

Enrollment timing for Part D: When you return to Original Medicare during AEP (effective January 1), you can also enroll in a standalone Part D plan during the same AEP window. When you return during MA OEP (effective first of the following month), you have a special enrollment period to pick up a Part D plan.

For more on Part D enrollment rules and how to avoid the late enrollment penalty, see our guide on reinstating a Part D plan.

Step-by-Step: How to Switch Back to Original Medicare

If you have decided to leave Medicare Advantage and return to Original Medicare, here is the process:

Step 1: Choose your enrollment window. Identify which window applies to your situation (AEP, MA OEP, or an SEP). Confirm the effective date of your disenrollment.
Step 2: Assess your Medigap options before disenrolling. If you do not have a guaranteed issue right, research whether you can qualify for Medigap coverage based on your current health. Do this before you drop your Medicare Advantage plan.
Step 3: Disenroll from your Medicare Advantage plan. Contact your plan directly or call 1-800-MEDICARE. You can also disenroll online at Medicare.gov.
Step 4: Enroll in a standalone Part D plan. Use the Medicare Plan Finder at Medicare.gov to compare Part D plans in your county based on your specific medications.
Step 5: Apply for Medigap coverage. If you have a guaranteed issue right, apply immediately. If you do not, apply as soon as possible and be prepared for underwriting.
Step 6: Confirm your coverage is active. Verify that your Original Medicare, Part D, and Medigap (if applicable) are all active before your Medicare Advantage plan ends.

For a personalized walkthrough of this process, schedule a free consultation with our team.

The Bottom Line on Switching Back to Original Medicare

Switching back to Original Medicare from Medicare Advantage is possible and sometimes the right move. Here is what to remember:

You can switch during AEP (Oct 15 to Dec 7) or MA OEP (Jan 1 to Mar 31)
The Medigap guaranteed issue right is the most important factor to evaluate before switching
Your first 12 months in Medicare Advantage is the safest window due to the trial right
Plan exits and service area changes also trigger guaranteed issue rights
You must enroll in a standalone Part D plan when you return to Original Medicare
Florida does not have year-round Medigap guaranteed issue, so health status matters outside of protected windows

Our licensed specialists can review your specific situation, confirm which rights apply to you, and help you compare Medigap plans before you make the switch. Schedule a free consultation to get started.