Can I Go Back to Original Medicare After Medicare Advantage Plan

Over 28 million Americans are enrolled in Medicare Advantage Plans as of 2023. But once you join a plan, can you change or switch later if it no longer meets your needs? This guide covers when and how to change your Medicare Advantage Plan so you can optimize your coverage.

Medicare Advantage Plan Basics

First, let’s quickly recap Medicare Advantage Plan basics:

Medicare Advantage Plans are offered by private insurers as an alternative way to receive your Medicare benefits.
These plans bundle together Medicare Part A, Medicare Part B, and usually Part D prescription drug coverage.
Many plans also offer extra benefits like dental, vision, and hearing coverage.
Each plan has a network of approved healthcare providers.

Now, on to the specifics of changing plans.

When Can You Change or Switch Plans?

There are designated times each year when you can make changes to your Medicare Advantage Plan enrollment.

Annual Enrollment Period

This yearly fall open enrollment window runs from October 15 to December 7. During this time, you can:

Switch from one Medicare Advantage Plan to a different one
Drop your Medicare Advantage Plan and return to Original Medicare
Sign up for a Medicare Advantage Plan if you have Original Medicare

Any changes made take effect January 1. This period offers an annual opportunity to evaluate your Medicare Advantage Plan and modify your coverage.

Medicare Advantage Open Enrollment Period

From January 1 to March 31 each year, you can:

Switch to a different Medicare Advantage Plan
Drop your Medicare Advantage Plan and go back to Original Medicare

Changes take effect the first of the month after you enroll. You can also join a stand-alone Medicare Part D prescription drug plan since your Medicare Advantage drug coverage will end.

Special Enrollment Periods

Certain qualifying life events allow you to change your Medicare Advantage Plan outside the usual enrollment windows. These include:

Moving out of your plan’s service area
Losing Medicaid coverage
Moving into or out of an institution like a nursing home
Gaining access to a 5-star rated Medicare Advantage Plan

Make sure you qualify for a Special Enrollment Period before attempting to switch plans outside normal enrollment periods.

How Do You Change or Switch Medicare Advantage Plans?

Follow this step-by-step process to smoothly transition from your current Medicare Advantage Plan into a new one:

Research the new Medicare Advantage Plan you want to switch into and make sure your doctors, medications, and hospitals are covered. Look for a plan meeting your needs and budget.
Inform your current Medicare Advantage insurer that you want to disenroll from their plan.
Enroll in the new Medicare Advantage Plan you’ve chosen. You can do this online, over the phone, or through a broker.
If switching back to Original Medicare, also select and enroll in a stand-alone Part D prescription drug plan.
Once your new coverage goes into effect, you can cancel your old Medicare Advantage Plan policy.

Following this checklist helps avoid gaps in coverage when transitioning between Medicare Advantage Plans or back to Original Medicare.

Can You Return to a Plan You Dropped?

If you’ve been enrolled in a Medicare Advantage Plan but decide to switch to another plan, can you re-enroll in the original plan later? Often, yes, but be aware of a few caveats.

The plan you were previously in may no longer be available down the road. Medicare Advantage Plan offerings can change from year to year.

Certain Medicare Advantage Plans establish “lock-out” periods for members who leave a plan but try to rejoin later. You may have to wait a set period before being allowed to enroll again.

Read plan details carefully, as your application to re-enroll could be denied if you developed certain health conditions after leaving the plan.

While usually you can return to a Medicare Advantage Plan you previously dropped, the plan landscape can change over time. Weigh your choices carefully before leaving an Medicare Advantage Plan you are satisfied with.

Should You Change Your Medicare Advantage Plan?

Here are some common reasons people consider switching Medicare Advantage Plans:

Your premium, deductible or copays increased substantially
Your medications are no longer covered or moved to a higher tier
Your doctor(s) have left the plan’s network
You need access to a specialty hospital that is out-of-network
You will be traveling a lot and need broader coverage
Plan quality, benefits, or formulary have declined
You moved to a new state or area
You want extra benefits like dental or vision

Think through your reasons to determine if shopping for a new Medicare Advantage Plan is your best option. Work with a Medicare agent or broker who can assess your situation and discuss the pros and cons of changing plans.

Key Steps for Changing Medicare Advantage Plans

To smoothly transition to a new Medicare Advantage Plan:

Check enrollment periods to verify when you can make changes
Research plans, benefits and costs to find options better suited to your needs
Inform your current insurer you want to disenroll
Enroll in the new Medicare Advantage Plan
Cancel your old Medicare Advantage Plan after your new coverage kicks in

With proper planning, you can change or switch into Medicare Advantage coverage that better fits your health profile and budget.

Takeaways for Changing Medicare Advantage Plans

You can change Medicare Advantage Plans during the fall open enrollment and spring Medicare Advantage open enrollment periods.
Special Enrollment Periods allow changes in limited situations like moving.
Notify your current plan you are disenrolling and enroll in your new chosen Medicare Advantage Plan.
Get quotes from multiple plans to find one that offers improved benefits or savings.
Consider any pre-approvals needed from your current insurer if you switch mid-year.

As your healthcare needs evolve, make sure your Medicare Advantage Plan still aligns with your care preferences and budget. Take advantage of enrollment windows to modify your coverage as required.

FAQS

Can I go back to Original Medicare after Medicare Advantage?

Yes, you can switch from a Medicare Advantage Plan back to Original Medicare.

What is the Medicare Open Enrollment period?

The Medicare Open Enrollment period is from October 15th to December 7th each year. It is the time when you can make changes to your Medicare coverage.

How can I change Medicare Plans?

You can change Medicare Plans by reviewing your options and enrolling in a new plan during the Medicare Open Enrollment period.

Is Original Medicare different from a Medicare Advantage Plan?

Yes, Original Medicare is different from a Medicare Advantage Plan. Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance), while a Medicare Advantage Plan combines Part A and Part B coverage into one plan.

Can I switch from Medicare Advantage to Original Medicare?

Yes, you can switch from a Medicare Advantage Plan to Original Medicare during the Medicare Open Enrollment period.

Can I switch from Original Medicare to a Medicare Advantage Plan?

Yes, you can switch from Original Medicare to a Medicare Advantage Plan during the Medicare Open Enrollment period.

Can I enroll in a Part D (prescription drug) plan when I switch from Medicare Advantage to Original Medicare?

Yes, you can enroll in a Part D Plan when you switch from Medicare Advantage to Original Medicare. It is recommended to have prescription drug coverage to avoid any gaps in your medication needs.

When can I make changes to my Medicare coverage?

You can make changes to your Medicare coverage during the Medicare Open Enrollment period, which occurs annually from October 15th to December 7th.

Can I switch to another Medicare Advantage Plan during the Medicare Open Enrollment period?

Yes, you can switch to another Medicare Advantage Plan during the Medicare Open Enrollment period, as well as switch from Original Medicare to a Medicare Advantage Plan or vice versa.

What happens if I miss the Medicare Open Enrollment period?

If you miss the Medicare Open Enrollment period, you may have to wait until the next enrollment period to make changes to your Medicare coverage. However, there are certain exceptions that may allow you to make changes outside of the enrollment period, such as qualifying for a Special Enrollment Period.

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