Can I drop my Medicare Advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage plan and go back to Original Medicare during a specific time each year.

Can I Drop My Medicare Advantage Plan and Go Back to Original Medicare?

Absolutely, you can switch from a Medicare Advantage plan back to Original Medicare. This option is available during a specific enrollment period designed for this purpose, allowing you to regain the flexibility and structure of Original Medicare.

When Can You Switch Back?

The primary window for dropping your Medicare Advantage plan and returning to Original Medicare is during the Medicare Advantage Open Enrollment Period (MA OEP).

• Dates: This period runs annually from January 1 to March 31.
• Purpose: If you are already enrolled in a Medicare Advantage Plan (with or without drug coverage), the MA OEP allows you to:
  • Switch to a different Medicare Advantage Plan (with or without drug coverage).
  • Drop your current Medicare Advantage Plan and return to Original Medicare (Part A and Part B).
• Important Note: If you return to Original Medicare, you will also have the opportunity to join a Medicare Prescription Drug Plan (Part D) at the same time.

How to Make the Switch

The process of switching from a Medicare Advantage plan back to Original Medicare generally involves a few steps:

1. Enroll in a Stand-Alone Medicare Part D Plan: If you want prescription drug coverage, the easiest way to drop your Medicare Advantage Plan during the MA OEP is often to enroll in a stand-alone Medicare Part D Prescription Drug Plan. When your new Part D plan takes effect, your Medicare Advantage Plan enrollment will automatically be canceled.
2. Contact Medicare: Alternatively, you can directly contact Medicare at 1-800-MEDICARE (1-800-633-4227) or your current Medicare Advantage plan to disenroll. They can guide you through the specific steps.
3. Consider Medigap: Once you're back on Original Medicare, you might want to purchase a Medicare Supplement Insurance (Medigap) policy to help cover out-of-pocket costs like deductibles, copayments, and coinsurance. Be aware that your ability to purchase a Medigap policy may be subject to medical underwriting if you are outside of specific guaranteed issue periods.
4. Effective Date: Changes made during the MA OEP typically become effective on the first day of the month following the month you make the change. For example, if you make the switch in February, your new coverage would begin March 1.

What Happens After You Switch Back to Original Medicare?

When you return to Original Medicare:

• Original Medicare (Part A & Part B): You will be covered by Medicare Part A (hospital insurance) and Part B (medical insurance). Original Medicare generally allows you to see any doctor or hospital nationwide that accepts Medicare.
• Medicare Part D (Prescription Drug Coverage): Your Medicare Advantage plan likely included prescription drug coverage. When you switch back to Original Medicare, you will need to enroll in a separate Medicare Part D Prescription Drug Plan to have drug coverage.
• Medicare Supplement Insurance (Medigap): Original Medicare does not have an annual out-of-pocket spending limit. Many people choose to purchase a Medigap policy from a private insurance company to help cover some of the costs that Original Medicare doesn't. Your ability to get a Medigap policy might depend on your health, unless you have specific "guaranteed issue rights" or are within your initial Medigap enrollment period.

Important Considerations Before Dropping Your Medicare Advantage Plan

Before making the decision to switch back to Original Medicare, carefully consider the following:

• Network Flexibility vs. Provider Choice: Medicare Advantage plans often operate with provider networks (HMOs, PPOs), while Original Medicare allows you to see any doctor, hospital, or supplier in the U.S. that accepts Medicare.
• Out-of-Pocket Costs:
  • Medicare Advantage plans have an annual out-of-pocket maximum, limiting your total spending on covered services. Original Medicare does not have this limit.
  • With Original Medicare, you'll generally pay 20% of the Medicare-approved amount for most doctor's services and outpatient therapy after meeting your Part B deductible.
• Extra Benefits: Many Medicare Advantage plans offer additional benefits not covered by Original Medicare, such as routine dental, vision, hearing, and fitness programs. These benefits would be lost if you switch back.
• Prescription Drug Coverage: As mentioned, if your Medicare Advantage plan included drug coverage, you must enroll in a separate Part D plan when you return to Original Medicare.
• Medigap Eligibility: This is crucial. If you are not within a guaranteed issue period, you may be subject to medical underwriting to purchase a Medigap policy. This means an insurance company can deny you coverage or charge you more based on your health conditions.

Key Enrollment Periods for Medicare

Understanding these periods can help you navigate your Medicare choices:

For more detailed and personalized information, it's always recommended to visit the official Medicare website or call 1-800-MEDICARE.