Yes, you can drop your Medicare Advantage plan and return to Original Medicare, but you can only do so during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year. During this time, you can switch to another Medicare Advantage plan or go back to Original Medicare.
Switching from a Medicare Advantage plan back to Original Medicare is a big decision, and there are a few things to consider before making the move. Whether you’re dissatisfied with your current plan, facing higher costs, or simply prefer the flexibility of Original Medicare, understanding your options and the steps to take will help ensure a smooth transition.
When Can You Switch?
- Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31): You can leave your Medicare Advantage plan and return to Original Medicare or switch to another Medicare Advantage plan.
- Annual Election Period (Oct 15 – Dec 7): This is when you can switch from Medicare Advantage to Original Medicare, with coverage starting on January 1.
- Special Enrollment Periods: If you qualify due to a life event—like moving out of your plan’s service area or losing employer coverage—you may be able to switch at other times.
What Happens When You Switch Back to Original Medicare?
Going back to Original Medicare means you’ll have Medicare Part A (hospital insurance) and Part B (medical insurance), but you might lose benefits like dental, vision, and prescription drug coverage that were included in your Medicare Advantage plan. You may need to enroll in a Medicare Part D plan to avoid penalties for late enrollment.
It’s also a good idea to consider a Medigap (Medicare Supplement) plan to help cover costs Original Medicare doesn’t, like copayments and deductibles.
Steps to Switch Back to Original Medicare
- Check if you’re eligible to switch during one of the designated enrollment periods.
- Contact Medicare or your current provider to disenroll from your Medicare Advantage plan.
- Enroll in a Medicare Part D plan (see options) if you need prescription drug coverage.
- Apply for a Medigap policy if you want additional coverage (compare plans).
Things to Consider Before Switching
- Coverage Differences: Medicare Advantage plans often include extra benefits that Original Medicare does not.
- Doctor Access: With Original Medicare, you can see any doctor who accepts Medicare, whereas Medicare Advantage plans typically have network restrictions.
- Cost Factors: Original Medicare has deductibles and coinsurance. Adding a Medigap plan can help, but it comes with an extra premium.
- Prescription Drug Coverage: If you return to Original Medicare, you’ll need a separate Part D plan to cover medications.
FAQs
1. Can I switch back to Medicare Advantage later?
Yes, but only during the Annual Election Period (Oct 15 – Dec 7) or if you qualify for a Special Enrollment Period.
2. Will I automatically get a Medigap plan if I switch?
No, Medigap plans require a separate enrollment. You may be subject to medical underwriting unless you qualify for guaranteed issue rights.
3. What happens to my prescription drug coverage if I drop Medicare Advantage?
You’ll need to enroll in a Medicare Part D plan separately to maintain prescription drug coverage and avoid late penalties.
4. Can I switch if I have a chronic health condition?
Yes, but if you need ongoing care, check how Original Medicare covers your treatments compared to your Medicare Advantage plan.
5. How do I get help choosing the best Medicare option?
Speaking with a licensed Medicare insurance agent can help you compare plans and find the right coverage for your needs. You can schedule a free consultation for personalized guidance.
Making the right Medicare choice can feel overwhelming, but you don’t have to figure it out alone. If you need help reviewing your options or making the switch, contact us to get expert assistance tailored to your situation.