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You can switch from Medicare Advantage to Original Medicare during an enrollment period that applies to you. Before you make the change, check its effective date, arrange prescription drug coverage if you need it, and confirm whether you have the right to buy Medigap. Returning to Original Medicare does not automatically guarantee a Medigap policy.
When you can leave Medicare Advantage
Medicare offers several windows for switching, depending on your situation. The change takes effect on a set date; submitting a request does not necessarily mean your new coverage starts immediately. Check the applicable dates and rules on Medicare.gov’s enrollment guidance.
October 15 through December 7: Annual Open Enrollment
During this annual period, you can switch from Medicare Advantage to Original Medicare. A change made by December 7 takes effect January 1.
January 1 through March 31: Medicare Advantage Open Enrollment
If you are already enrolled in Medicare Advantage, you can leave the plan and return to Original Medicare during this period. You may also join a separate Medicare drug plan. The change generally takes effect on the first day of the month after the plan receives your request. You can make only one change during this period.
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Other windows that may apply
If you joined Medicare Advantage during your Initial Enrollment Period, you may be able to return to Original Medicare during the first three months you have Medicare Part A and Part B. A Special Enrollment Period may also apply after certain events, such as moving or losing or changing other coverage. The qualifying event determines the exact rules and deadline.
How to make the switch
- Identify your enrollment period. Confirm that you qualify to make the change now, and note the deadline for the period that applies to you.
- Confirm the effective date. For a December 7 deadline, a change takes effect January 1. During the January 1–March 31 period, it generally takes effect the first of the month after the plan receives the request.
- Submit the change through an applicable enrollment route. Follow Medicare’s instructions for your circumstances, and confirm that the request was received and when your Advantage coverage will end.
- Arrange prescription drug coverage. If you need Part D, choose a standalone drug plan and confirm its start date. Do not assume your existing Advantage plan’s drug coverage will continue after you leave.
- Check Medigap eligibility and timing. Before relying on a supplement to help with Original Medicare costs, verify whether you have an open-enrollment, trial, or guaranteed-issue right and what deadlines apply in your state.
- Keep confirmation and coverage records. Save notices showing when your Advantage plan ends and any confirmation of new drug or Medigap coverage.
Plan for prescription drug coverage
Original Medicare consists of Part A and Part B; it does not include prescription drug coverage by itself. Most Medicare Advantage plans include Part D, but you may need to enroll in a standalone Part D plan when you return to Original Medicare. Check how the old plan’s drug coverage ends and the new plan’s coverage begins. Medicare says that going 63 or more consecutive days without creditable prescription drug coverage may lead to a Part D late-enrollment penalty. See Medicare.gov’s guidance on avoiding penalties.
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Check Medigap rights before you switch
Medigap helps pay certain costs in Original Medicare, but it is not a substitute that can be used to pay Medicare Advantage plan costs. Leaving Medicare Advantage does not automatically guarantee that an insurer will sell you a Medigap policy. Your options depend on when you first had Part B, your history with Medigap and Medicare Advantage, the reason you are leaving, and state protections.
Six-month Medigap Open Enrollment Period
Medicare.gov describes a six-month Medigap Open Enrollment Period that begins when you are 65 or older and have Medicare Part B. During this period, an insurer generally cannot use health questions to deny you a policy or change its price. Outside it, federal law does not guarantee that an insurer will sell you a policy unless a specific guaranteed-issue right applies; state law may provide additional protections. Read Medicare.gov’s Medigap buying guidance.
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Some people have a trial right when they leave Medicare Advantage. For example, if you dropped a Medigap policy to join Medicare Advantage for the first time, you may have 12 months to get your prior policy back if the same insurer still sells it. People who first joined Medicare Advantage when first eligible for Part A at age 65 may also have a first-year opportunity to switch back and buy certain Medigap policies. The right depends on your exact circumstances and state rules.
Guaranteed-issue timing
For certain guaranteed-issue situations, Medicare.gov says you can apply starting 60 days before your Medicare Advantage coverage ends and no later than 63 days after it ends. A Medigap policy cannot start until that Advantage coverage ends. Keep notices that establish the end date and check your specific right with Medicare or your State Insurance Department. See Medicare.gov’s guidance on when to buy Medigap.
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Compare what you gain and give up
| Factor | Original Medicare | Medicare Advantage |
|---|---|---|
| Provider access | You can see any doctor or hospital that takes Medicare, anywhere in the U.S., according to Medicare.gov’s coverage overview. | Many plans use provider networks; check whether your doctors and hospitals are included. |
| Prescription drugs | Part A and Part B do not include drug coverage by themselves; you may need a separate Part D plan. | Most plans include Part D, though you should check the specific plan. |
| Medigap | You may be able to buy a Medigap policy, depending on your rights, eligibility, and state law. | Medigap generally cannot pay Medicare Advantage plan costs. |
| Extra benefits | Medicare.gov’s overview contrasts Original Medicare with Advantage plans that may offer extra benefits. | Some plans offer benefits such as vision, hearing, or dental coverage. |
| Costs and benefits | Actual costs depend on your coverage choices and circumstances; no single amount applies to everyone. | Costs and benefits vary by plan and location; compare the specific plan available to you. |
Before you submit a change
- Write down the enrollment deadline and the date your new coverage is expected to begin.
- Check whether your current plan includes Part D and coordinate the end date with any standalone drug plan you choose.
- Determine whether you have a Medigap right before assuming you can buy a policy, and check the state-specific rules.
- Compare provider access, drug coverage, supplemental coverage, extra benefits, and plan-specific costs for your location.
- Contact Medicare or your State Insurance Department if your eligibility or deadlines are unclear.
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