Medicare Advantage plans offer bundled benefits, but restrict your choice of providers. With Original Medicare you can see any doctor. So can you switch from Medicare Advantage back to Original Medicare without penalty?
The short answer is yes – you can go back to Original Medicare during certain enrollment periods with no penalty. However, your ability to purchase supplemental coverage may be impacted depending on when and how you switch.
Read on to learn more about penalties and processes for changing from Medicare Advantage back to Original Medicare.
Medicare Advantage vs. Original Medicare
First, a quick recap of the differences between Medicare Advantage (Part C) and Original Medicare:
Medicare Advantage
- Offered by private insurers
- Bundles Part A, Part B, and usually Part D
- Restricted provider network
- Out-of-pocket costs vary
- May have extra benefits
Original Medicare
- Government-administered Parts A and B
- Freedom to see any doctor
- Need separate Part D plan
- Need supplemental coverage (Medigap)
- Standard out-of-pocket costs
Medicare Advantage plans appeal to some enrollees because they consolidate coverage into one plan. But provider networks can be restrictive. With Original Medicare you have open access.
When Can I Switch from Medicare Advantage Back to Original Medicare?
These two key enrollment periods allow you to drop your Medicare Advantage plan and switch back to Original Medicare without penalty:
Annual Election Period (October 15 – December 7)
- Disenroll from your Medicare Advantage Plan
- Enrollment in Original Medicare takes effect January 1
Medicare Advantage Open Enrollment Period (January 1 – March 31)
- Disenroll from your Medicare Advantage Plan
- Enrollment in Original Medicare takes effect the first of the following month
Outside of these windows, you can only switch back to Original Medicare under certain special circumstances like moving out of your plan’s service area.
What About Supplemental Coverage?
Along with Parts A and B, Original Medicare requires you to purchase separate Part D prescription drug coverage. Most enrollees also get a Medigap policy to cover out-of-pocket costs.
If you already had Medigap and dropped it when you joined Medicare Advantage, you can switch back during your trial period. After that, there is no guarantee of being able to get Medigap coverage.
You can enroll in a Part D drug plan without penalty during applicable enrollment periods.
Are There Penalties for Switching Back to Original Medicare?
As long as you disenroll during an enrollment period, there are no penalties from Medicare for switching from Medicare Advantage back to Original Medicare.
However, your ability to purchase supplemental coverage could be impacted depending on your situation:
- After your first year – No guarantee of Medigap acceptance if you want to switch back
- No previous Medigap – Can’t obtain it with guarantees unless in trial period
- Delayed Part D – May face a late enrollment penalty later on
So while Medicare won’t penalize you directly, your choices for supplemental coverage could be limited if you don’t switch back during your trial period.
The Trial Period for Medicare Advantage
Within your first year in a Medicare Advantage plan, you have a one-time trial right allowing you to go back to Original Medicare penalty-free.
This trial period allows you to:
- Return to your previous Medigap policy if you had one
- Enroll in a Part D plan without penalty
So if you want to keep open access to Medigap coverage, be sure to switch back during your trial period.
How Do I Switch Back to Original Medicare?
To disenroll from Medicare Advantage, contact Medicare in one of these ways:
- Call 1-800-MEDICARE
- Visit your local Social Security office
- Contact your Medicare Advantage insurer to request disenrollment
There are no special forms required. Just specify you want to drop your Medicare Advantage plan and return to Original Medicare.
The change will take effect at the start of the following month or year depending on when you initiate the switch.
What Should I Consider Before Switching?
Before you switch from Medicare Advantage back to Original Medicare, consider:
- Provider access – Is an open network important?
- Prescription drugs – Make sure you enroll in Part D along with Parts A/B
- Medigap eligibility – Will a policy be available if you wait past the trial period?
- Out-of-pocket costs – Account for Medigap premiums and Part D costs
- Total coverage – Do you lose any extra benefits from Medicare Advantage?
Weigh your options carefully before exiting Medicare Advantage. But know you can go back to Original Medicare penalty-free during key enrollment periods.
Frequently Asked Questions
If I switch to Original Medicare can I get Medigap immediately?
If it’s your trial period, yes. Otherwise you may need to undergo medical underwriting and could be denied coverage.
When I go back to Original Medicare do I have to re-enroll in Part B?
No, your existing Part B enrollment carries over automatically. You just need to add a Part D plan and potentially Medigap.
Can I switch between Medicare Advantage and Original Medicare each year?
Yes, you can change plans annually during open enrollment periods. There are no limits on how often you can switch.
Does my doctor’s acceptance of Original Medicare guarantee they’ll take new patients?
No, your provider may be enrolled in Medicare but still limit new patients. Check with them before switching plans.
If my Medigap application is denied can I stay on Medicare Advantage?
Yes, a denied Medigap application does not impact your existing Medicare Advantage enrollment.
The Bottom Line
You can go back to Original Medicare from Medicare Advantage during annual enrollment periods without penalty. But supplemental coverage limitations may apply if you switch outside your trial period.
Carefully weigh your provider, prescription drug, and out-of-pocket costs before exiting your Medicare Advantage plan. But know you always have the option to return to original Medicare if needed.
It’s Not Always Easy to Switch from Medicare Advantage to Supplement
FAQ
Can I drop my Medicare Advantage plan and go back to original Medicare?
What happens when I Disenroll from a Medicare Advantage plan?
Why are people leaving Medicare Advantage plans?
Can you go back to Medicare supplement after Medicare Advantage?