Many people enrolled in Medicare Advantage later decide they want to switch back to Original Medicare. Whether you want more freedom to choose providers, are dealing with high out-of-pocket costs, or are unsatisfied with plan changes, you may be considering making the change to Original Medicare. But is it difficult to switch from Medicare Advantage Plans?
Medicare Advantage Plans are an alternative way to receive your Medicare benefits from private insurers. Also known as Medicare Part C, Medicare Advantage Plans provide all of your Part A and Part B coverage and often include extra benefits like vision, dental, hearing, and prescription drugs. However, networks are limited and out-of-pocket costs can be unpredictable.
Under Original Medicare, you receive your Part A hospital and Part B medical coverage directly from the federal government. You can see any provider nationwide who accepts Medicare. You can also add supplemental coverage through a Medigap Plan and a separate Medicare Part D Plan.
There are several common reasons people consider switching from MA plans back to Original Medicare:
To have freedom in choosing providers and specialists without network restrictions
Avoiding the prior authorizations and referrals required by many MA plans
Dissatisfaction with frequent changes in MA plan coverage, networks, and costs
High out-of-pocket costs under many MA plans
Prefer the supplemental coverage options like Medigap Plans not available in MA
The process to switch from a Medicare Advantage Plan back to Original Medicare is fairly straightforward. Here are the steps:
First, check to see if you're eligible to make a change. The Annual Enrollment Period each fall or Medicare Advantage Open Enrollment Period from January 1 to March 31 are the most common times.
Next, review Original Medicare options like Medigap Plans and Part D drug plans. Enroll in the plan(s) you want for supplemental coverage.
Disenroll from your Medicare Advantage Plan. You can enroll in Original Medicare online, by calling 1-800-MEDICARE, or directly through your plan.
Finally, send your request to leave your Medicare Advantage Plan. Your coverage will switch over the first of the following month after the plan gets your request.
The two main times you can switch from Medicare Advantage Plans back to Original Medicare include:
Annual Enrollment Period: October 15 to December 7 each year for coverage effective January 1
Medicare Advantage Open Enrollment Period: January 1 to March 31 each year for coverage effective the first of the next month
Outside these periods, your ability to switch plans is limited so it's important to pay attention to enrollment deadlines.
Freedom to see any provider who accepts Medicare
No referrals needed to see specialists
Lower out-of-pocket costs with supplemental coverage
Access to Medigap Plans for more coverage
Possibly higher premiums for Medigap Plans
Need to enroll in Part D prescription plan separately
No additional benefits like vision and dental
While it takes some preparation, it is not overly difficult to switch from Medicare Advantage Plans back to Original Medicare. Carefully consider your options during enrollment periods, choose supplemental coverage, and submit your disenrollment request to make the change. Planning ahead ensures you end up with the right Medicare coverage.
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Bourgeois Insurance a Call at (985) 803-8999. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
From October 15 - December 7 each year, you can enroll in or change your Medicare Advantage or drug coverage, effective the following January 1.
During your initial enrollment period - the 7 months surrounding your 65th birthday. After that you may pay higher premiums without qualifying health coverage.
The annual open enrollment period is the main time, but you can also switch to Original Medicare within the first 3 months of the year if dissatisfied.
From January 1-March 31 each year you have a trial period to disenroll from an Advantage Plan and return to Original Medicare.
During your initial enrollment period for Part D, or the annual open enrollment period. You may pay penalties if enrollment is delayed without qualifying coverage.
Original Medicare is government-run Parts A & B. Advantage Plans, also called Part C, are run by private insurers under contract with Medicare.
Use the Medicare Plan Finder to search for prescription drug plan on Medicare.gov for personalized plan comparisons and to enroll online or print a form to complete by mail.
The annual open enrollment period from October 15 to December 7 applies to changes between MA plans or addition/drop of drug coverage within MA plans.
You may face late penalties on your Part B or Part D premiums for as long as you have that coverage. Enroll when first eligible to avoid premium increases.
Generally no - guaranteed issue rights exist for Medigap during enrollment windows or qualifying life events like moving out of a plan's service area.
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Plans are insured or covered by Medicare Advantage (HMO, PPO, and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan in your area. Please contact medicare.gov or 1-800-Medicare to get information on all your options.
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