Switching from Medicare Advantage to Original Medicare
Turning 65 often comes with major healthcare decisions—one of the most important being your Medicare coverage. While many people initially choose a Medicare Advantage plan, some later realize that Original Medicare better fits their healthcare needs. If you’re rethinking your coverage, it’s important to know that switching back from Medicare Advantage to Original Medicare is possible—but timing and rules matter.
If you live in Beaverton, OR, and want to explore your Medicare switch options, MichaelsMedicareMinistry can be a helpful resource. With local expertise and personalized guidance, they assist individuals in navigating the transition smoothly.
📍 15125 SW Ruby Ct, Beaverton, OR 97007
📞 +1 (503) 828-2328
📧 wmichaeljarman@gmail.com
Why Someone Might Switch Back
While Medicare Advantage (Part C) offers all-in-one plans with extra perks like dental, vision, and hearing coverage, it may come with network restrictions, referral requirements, or unexpected out-of-pocket costs. Original Medicare, on the other hand, offers greater provider flexibility and predictable fee-for-service structures—especially when combined with a Medicare Supplement (Medigap) plan.
When Can You Switch?
You can’t change your Medicare plan just anytime—specific periods allow for changes. These include:
Medicare Advantage Open Enrollment Period (January 1 – March 31)
During this period, if you’re already enrolled in a Medicare Advantage plan, you can
- Switch to a different Medicare Advantage plan, or
- Drop your plan and return to Original Medicare
Annual Enrollment Period (October 15–December 7)
During AEP, you can switch
- From Medicare Advantage to Original Medicare
- From one Medicare Advantage plan to another
- Add or drop a Part D (prescription drug) plan
Special Enrollment Periods (SEPs)
These are triggered by qualifying life events, such as:
- Moving out of your plan’s service area
- Losing employer coverage
- Eligibility changes due to Medicaid or Extra Help
What Happens When You Switch Back?
Switching to Original Medicare (Part A and Part B) is relatively straightforward, but there are a few important things to remember:
You May Need a Part D Plan
Original Medicare doesn’t include prescription coverage. If you’re leaving a Medicare Advantage plan that bundled drug coverage, be sure to enroll in a standalone Part D plan.
You Might Want a Medigap Plan
Medicare Supplement (Medigap) insurance helps cover copayments, coinsurance, and deductibles under Original Medicare. However, guaranteed acceptance into a Medigap plan only applies during your initial enrollment or certain SEPs. If you apply later, insurers can deny coverage or charge more based on your health history.
Things to Consider Before Making the Switch
Switching from Medicare Advantage to Original Medicare isn’t just a paperwork decision—it impacts your:
- Access to doctors and hospitals
- Out-of-pocket costs
- Coverage for services like dental and vision
Take time to evaluate:
- Are your current providers covered under Original Medicare?
- Can you afford a Medigap plan for extra protection?
- Do you need dental, vision, or hearing care often?
Local Help in Beaverton, OR
If you’re feeling overwhelmed or unsure, it helps to talk to someone who understands the local Medicare landscape. Whether you’re new to Medicare or considering switching, MichealsMedicareMinistry in Beaverton provides tailored advice to help you make informed decisions.
📍 15125 SW Ruby Ct, Beaverton, OR 97007
📞 +1 (503) 828-2328
📧 wmichaeljarman@gmail.com
FAQs
Can I switch from Medicare Advantage to Original Medicare at any time?
No, you can only switch during specific periods like the Medicare Advantage Open Enrollment (Jan 1–Mar 31) or Annual Enrollment Period (Oct 15–Dec 7), unless you qualify for a Special Enrollment.
Will I lose drug coverage if I leave my Medicare Advantage plan?
Yes, unless you enroll in a standalone Medicare Part D plan for prescription drugs.
Can I get a Medigap plan after switching back?
Yes, but you may be subject to medical underwriting unless you’re in a guaranteed-issue window.
Does Original Medicare offer dental, vision, or hearing coverage?
No, these are typically not included in Original Medicare. Consider standalone plans if those benefits are important to you.
Where can I get help deciding whether to switch?
For personalized assistance in Beaverton, contact MichealsMedicareMinistry at 📞 +1 (503) 828-2328 or 📧 wmichaeljarman@gmail.com.
