Yes, you can switch from Medicare Advantage to Original Medicare, but the timing and rules matter

You can move from a Medicare Advantage plan to Original Medicare (Parts A and B) during specific windows each year. The most common window is the Annual Enrollment Period, which runs October 15 to December 7. During this time, you can switch to Original Medicare, and your coverage starts January 1. You can also switch during the Medicare Advantage Open Enrollment Period (January 1 to March 31), though coverage starts the first of the following month.

If you have a may have access to life event — such as moving out of your plan's service area, losing employer coverage, or becoming may be able to access for Medicaid — you may be able to switch outside these windows. A may have access to event gives you a 60-day window to make the change. Outside of these periods, you are locked into your current plan until the next enrollment window opens.

Key Takeaways

  • You can switch during the Annual Enrollment Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31) each year.
  • A may have access to life event such as moving or losing coverage opens a 60-day window to switch outside regular enrollment periods.
  • When you switch to Original Medicare, you should also choose a Medigap or Part D plan at the same time to avoid gaps in coverage.
  • Tell your current Medicare Advantage plan you are leaving; do not wait for your new coverage to start.
  • You have may provide issue rights for Medigap plans within 63 days of losing Medicare Advantage coverage, meaning insurers cannot deny you or charge more based on health.

What happens to your current plan when you switch

Your Medicare Advantage plan ends on the last day of the month in which your Original Medicare coverage begins. If you enroll during the Annual Enrollment Period in October or November, your new coverage starts January 1 and your Advantage plan ends December 31. If you switch during the January to March window, your coverage typically starts the first of the following month.

You must notify your current Medicare Advantage plan that you are leaving. Do not assume the plan will know automatically. Call the plan's customer service number (on your card) and tell them your last day of coverage. Ask for written confirmation. This step prevents billing problems and ensures the plan stops charging premiums after your switch date.

Choosing Medigap and Part D coverage at the same time

Original Medicare covers hospital and doctor visits, but it does not cover all costs. Most people who switch to Original Medicare also choose a Medigap policy (supplemental insurance) to cover copayments, coinsurance, and deductibles. You have the strongest protection if you enroll in Medigap within 63 days of losing your Medicare Advantage coverage. During this window, insurance companies must sell you any Medigap plan they offer, regardless of your health history — this is called may provide issue.

Original Medicare also does not cover prescription drugs. You will need to choose a Part D plan (prescription drug coverage) during the same enrollment period. If you do not choose Part D when you switch to Original Medicare, you may pay a penalty if you enroll later. The penalty is 1% of the national average Part D premium for each month you went without coverage.

You can enroll in Medigap and Part D through insurance companies directly, or you can call Medicare at 1-800-MEDICARE to get a list of plans available in your area.

may have access to life events that let you switch outside enrollment periods

If you experience a may have access to event, you can switch to Original Medicare within 60 days of the event, even if it is not October or January. may have access to events include moving out of your plan's service area, losing your plan because the insurer stopped offering it in your area, becoming newly may be able to access for Medicaid, or losing other health coverage (such as employer coverage or TRICARE).

To use a may have access to event, you must contact Medicare within 60 days and provide proof of the event. Call 1-800-MEDICARE or visit Medicare.gov to report the event and start your switch. Keep documentation of the event — a lease showing your new address, a letter from your employer, or a Medicaid approval notice — in case Medicare asks for proof.

What to do before your switch date

Start the process at least one month before you want your new coverage to begin. This gives you time to research plans, enroll, and notify your current plan. Make a list of the doctors and specialists you see regularly, then check whether they accept Original Medicare and whether they participate in the Medigap plans you are considering. Not all doctors accept all Medigap plans.

If you take prescription medications, compare Part D plans using the Medicare Plan Finder tool at Medicare.gov. Enter your medications to see which plans cover them and at what cost. Costs vary widely between plans, so comparing now can save you hundreds of dollars per year.

Request your medical records from your current Medicare Advantage plan before your switch date. Ask for a summary of any recent test results, hospitalizations, or ongoing treatments. This information helps your new doctors understand your health history and prevents duplicate testing.

What to expect after you switch

Your new Original Medicare coverage begins on the date you selected during enrollment. You will receive a new Medicare card in the mail if your plan changes. Keep your old card until you receive the new one, in case you need to show proof of coverage at a doctor's office.

Your first doctor's visit on Original Medicare may take longer than you are used to. Some offices are unfamiliar with Medigap plans or may not have your records yet. Bring your new Medicare card, your Medigap card, and any medical records you obtained from your previous plan. Tell the office staff that you have switched plans so they can update their records.

If you switched during the Annual Enrollment Period, your new coverage starts January 1. If you switched during the January to March window, your coverage starts the first of the following month. Mark your calendar for the next Annual Enrollment Period so you can review your Medigap and Part D plans each year.

When switching to Original Medicare makes sense

Some people switch because their doctor is not in their Medicare Advantage plan's network. Others switch because their plan's costs have risen or the plan no longer covers the services they need. Some switch because they are moving to a state where their current plan does not operate.

Before you switch, compare the total cost of Original Medicare plus Medigap plus Part D against the cost of staying in your Medicare Advantage plan. Original Medicare has no network restrictions, but Medigap premiums can be high. Medicare Advantage has lower or no premiums, but you may pay more at the point of care and face network limits. The right choice depends on your health, your doctors, and your budget.

Frequently Asked Questions

Can I switch back to Medicare Advantage after I choose Original Medicare?

Yes, but only during the Annual Enrollment Period (October 15 to December 7). You cannot switch back during the January to March Medicare Advantage Open Enrollment Period. If you switch to Original Medicare and then want to return to Advantage, you must wait until October to make the change.

What if my doctor does not accept Original Medicare?

Most doctors accept Original Medicare, but some do not. Call your doctor's office before you switch and ask whether they accept Original Medicare and whether they participate in the Medigap plans you are considering. If your doctor does not accept Original Medicare, you may need to find a new doctor or stay in Medicare Advantage.

Do I have to choose Medigap when I switch to Original Medicare?

No, Medigap is optional. However, without it you will pay copayments and coinsurance for doctor visits and hospital stays. Many people find that Medigap costs less than the out-of-pocket costs they would pay without it. You have the best rates if you enroll within 63 days of leaving Medicare Advantage.

What happens to my prescriptions when I switch?

Your current prescriptions will not automatically transfer to a new Part D plan. You must choose a Part D plan during the same enrollment period. If your new plan does not cover one of your medications, you can ask the plan for an exception, or you can pay out of pocket until the next enrollment period.

Can I switch if I am in the middle of a hospital stay or treatment?

Yes, but timing matters. If you are in the hospital when your new coverage starts, Original Medicare will cover the hospital stay. However, it is better to wait until after treatment ends if possible, so you do not have claims split between two plans. Contact Medicare to discuss your specific situation.