Many Medicare beneficiaries enroll in Medicare Advantage (Part C) for added benefits like dental, vision, and lower out-of-pocket costs. But what if you’re unhappy with your plan? Can you switch back to Original Medicare?
The short answer: Yes, but timing matters.
In this guide, we’ll cover:
✅ When and how to switch back to Original Medicare
✅ Whether you can still get a Medigap policy
✅ Cost and coverage differences between Medicare Advantage and Original Medicare
⏳ When Can You Switch from Medicare Advantage to Original Medicare?
You can leave Medicare Advantage and return to Original Medicare (Parts A & B) during specific enrollment periods:
1️⃣ Medicare Advantage Open Enrollment (Jan 1 – March 31)
✔ Switch from Medicare Advantage to Original Medicare
✔ Enroll in a Part D prescription drug plan
✔ Change takes effect the next month
2️⃣ Annual Enrollment Period (Oct 15 – Dec 7)
✔ Drop Medicare Advantage and return to Original Medicare
✔ Add a Part D plan
✔ Coverage starts January 1
3️⃣ Special Enrollment Periods (SEPs)
✔ If you move, lose coverage, or qualify for an exception, you may be eligible.
🛑 Can You Still Get a Medigap Plan After Switching?
If you’re returning to Original Medicare, you may want Medigap (Medicare Supplement) to help cover costs like copays and deductibles.
✅ Guaranteed Issue Right (No Medical Underwriting)
- If you’re in your first 12 months of Medicare Advantage, you have a “trial right” to get a Medigap plan without health questions.
❌ Medical Underwriting May Apply
- If more than 12 months have passed, you may need to pass health underwriting to get a Medigap plan.
- Insurance companies can deny coverage or charge higher rates based on your health history.
💰 Cost & Coverage Differences: Medicare Advantage vs. Original Medicare
| Feature | Medicare Advantage | Original Medicare |
|---|---|---|
| Doctor & Hospital Network | Limited to network providers | Any doctor/hospital accepting Medicare |
| Monthly Premium | $0 - $100 (varies by plan) | $174.70 (Part B premium in 2025) |
| Medigap Eligibility | ❌ Not available | ✅ Available (if approved) |
| Prescription Drug Coverage | Usually included | Requires separate Part D plan |
| Out-of-Pocket Costs | Has an out-of-pocket max | No spending cap (Medigap helps) |
Can I drop Medicare Advantage anytime?
❌ No. You must wait for an official enrollment period unless you qualify for a Special Enrollment Period.
Will I automatically get a Medigap plan if I switch?
❌ No. Medigap requires separate enrollment, and you may need to pass medical underwriting unless you qualify for a guaranteed issue right.
🔹 If you prefer lower upfront costs & extra benefits, Medicare Advantage may be better.
🔹 If you want doctor freedom, Medigap, and no networks, Original Medicare is likely the better choice.
🔹 Before switching, check Medigap availability—you may not get your ideal plan without guaranteed issue rights.
📌 Next Steps:
- Compare Medigap vs. Medicare Advantage before switching.
- Call 920-545-4884 or visit Medicare.gov for help.
- If eligible, enroll in Part D to avoid late penalties.
