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How to switch back to Original Medicare

Published by MedicareQuotesForYou. Published . Last reviewed .

Short answer

Leaving a Medicare Advantage plan is straightforward. Doing it without leaving a hole in your coverage takes three moves, not one.

When you can go. Two regular windows. The Annual Enrollment Period, October 15 to December 7, with the change effective January 1. Or the Medicare Advantage Open Enrollment Period, January 1 to March 31, which you can use once if you are in an Advantage plan on January 1, effective the first of the following month. Special Enrollment Periods open other windows if your plan is ending, you move, or your circumstances qualify.

What you must arrange at the same time. Original Medicare does not include prescription drug coverage, so you need a stand-alone Part D plan or you risk a permanent late enrollment penalty. And Original Medicare has no annual limit on what you pay, which is why most people returning to it also want a Medigap policy.

The order matters more than anything else on this page. Outside a guaranteed-issue window, insurers in most states may review your medical history and decline you or charge more for Medigap. So apply for the Medigap policy and get an acceptance before you disenroll from the Advantage plan — not after. Doing it the other way round is the single most expensive mistake in this process.

Your windows and what each one does

When you can leave a Medicare Advantage plan, and when the change takes effect.
WindowDatesWhat you can doEffective
Annual Enrollment Period October 15 to December 7, every year Drop Advantage, return to Original Medicare, join a Part D plan, or switch Advantage plans. No limit on changes; the last one on file wins. January 1
Medicare Advantage Open Enrollment Period January 1 to March 31 One change, if you are in an Advantage plan. Return to Original Medicare with a Part D plan, or move to a different Advantage plan. First of the month after the request is processed
Trial right, first year Within 12 months of joining an Advantage plan when you first became eligible at 65 Drop the plan and return to Original Medicare with guaranteed-issue Medigap rights. The strongest position on this page. Generally the first of the following month
Plan is discontinued or leaves your area Normally December 8 to the last day of February Return to Original Medicare, again with a guaranteed-issue Medigap right. See our guide to a plan being discontinued. Varies; the notice letter states your dates
5-star Special Enrollment Period Once, December 8 to November 30 Move to a 5-star plan where one is offered. Relevant only if you are switching plans rather than leaving Advantage entirely. First of the following month
Other Special Enrollment Periods Varies Moving out of the service area, entering or leaving an institution, gaining or losing Medicaid or Extra Help, and other qualifying changes. Varies
The Medigap underwriting trap Nothing about leaving a Medicare Advantage plan entitles you to buy a Medigap policy. They are two separate decisions with two separate sets of rules. Your strongest right to buy any Medigap policy sold in your state, regardless of health, is normally the six-month window that opens when you are 65 or older and enrolled in Part B. If that has passed and you do not have a trial right or another guaranteed-issue situation, then in most states an insurer may look at your medical history and say no. Establish whether you can get the supplement before you give up the plan you have.

The steps, in the order that protects you

  1. Work out whether you have a guaranteed-issue right. Are you within 12 months of first joining an Advantage plan at 65? Is your plan being discontinued? Are you moving out of its service area? Does your state grant broader rights than the federal minimum? Any of these changes the whole calculation, and a licensed agent can confirm your situation in a few minutes.
  2. Apply for the Medigap policy first, and get the acceptance in writing. Ask the insurer for the effective date you want, which should be the day after your Advantage coverage ends. Do not cancel anything yet.
  3. Choose a stand-alone Part D plan. Check that every medication you take is on that plan's drug list, and check the pharmacies — costs commonly differ between a plan's preferred and standard pharmacies.
  4. Now disenroll from the Advantage plan. If your Advantage plan includes drug coverage, enrolling in a stand-alone Part D plan generally disenrolls you from it automatically. Do not rely on that alone: confirm it. You can also call 1-800-MEDICARE, use your account on Medicare.gov, or send the plan a written disenrollment request.
  5. Get written confirmation of all three moves — the disenrollment, the Part D enrollment and the Medigap policy — and keep them together with the effective dates.
  6. Check the handover actually happened. Before your first appointment under the new arrangement, confirm that your Medicare card is being used, the Medigap policy is in force and the Part D plan is showing at your pharmacy. Do not assume; the first claim is where errors surface.

What changes when you are back on Original Medicare

Some of it is a relief and some of it needs planning for. Being straight about both is the point of this page.

Practical differences after returning to Original Medicare.
What improvesWhat you take on
Any provider in the United States that accepts Medicare will see you. No network, no referrals for most care. No annual out-of-pocket maximum unless you add a Medigap policy. This is the reason the supplement matters.
Prior authorisation is far less common, so treatment is less likely to be delayed by an approval process. Prescription drug coverage is a separate plan you have to choose and pay for, and going without creditable coverage can create a permanent penalty.
Coverage travels with you anywhere in the country, which matters if you spend part of the year elsewhere. Extra benefits that came bundled with the Advantage plan — dental, vision, hearing, fitness, over-the-counter allowances — generally end.
Costs become predictable rather than event-driven, once a supplement is in place. Higher, steadier monthly outlay: the Part B premium, plus a Medigap premium, plus a Part D premium.

Whether that trade is worth it is a genuine judgment call, not a foregone conclusion. Our Advantage versus Original Medicare comparison sets out both sides, and Advantage versus Medigap covers what a supplement does and does not do.

Frequently asked questions

How do I switch back to Original Medicare from Medicare Advantage?

During a valid window, disenroll from the Advantage plan and your Part A and Part B coverage resumes as Original Medicare. You can call 1-800-MEDICARE, use your account on Medicare.gov, or send the plan a written disenrollment request. If your Advantage plan includes drug coverage, enrolling in a stand-alone Part D plan generally disenrolls you from it automatically. Arrange Part D, and Medigap if you want it, before you disenroll.

When can I leave my Medicare Advantage plan?

During the Annual Enrollment Period, October 15 to December 7, effective January 1. Or once during the Medicare Advantage Open Enrollment Period, January 1 to March 31, effective the first of the following month. Special Enrollment Periods open other windows if you move, your plan ends, or your circumstances qualify.

Can I get a Medigap policy if I leave Medicare Advantage?

Not automatically. Leaving an Advantage plan does not by itself give you the right to buy a supplement. Outside a guaranteed-issue situation, insurers in most states may use medical underwriting and can decline you or charge more. Guaranteed-issue situations include a trial right within 12 months of first joining an Advantage plan at 65, your plan being discontinued, and moving out of the service area. A few states grant broader rights. Confirm yours before disenrolling.

Do I need a Part D plan if I go back to Original Medicare?

Unless you have other creditable drug coverage, yes. Original Medicare does not cover most prescription drugs, and going without creditable coverage after you are first eligible can add a late enrollment penalty to your premium permanently. Choose the Part D plan at the same time as everything else, not afterwards.

Will I lose my dental, vision and hearing benefits?

Generally yes. Those are extra benefits your Advantage plan chose to include; Original Medicare does not cover routine dental, vision or hearing care. Some people buy stand-alone dental or vision policies instead. Weigh what those would cost against what the Advantage plan's version actually paid out, which is often less than the brochure implies.

How long does it take to switch back to Original Medicare?

The paperwork is quick; the effective date is what matters. A change made during the Annual Enrollment Period takes effect on January 1. A change made in the January to March window takes effect the first of the month after it is processed. Allow time for the Medigap application, since underwriting can take several weeks where it applies — another reason to start with the supplement.

Check whether you can get a supplement before you switch

Tell us a little about yourself and a licensed insurance agent can check whether you have a guaranteed-issue right, what Medigap policies are available where you live, and how the Part D piece fits. There is no cost and no obligation.

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