I picked the wrong Advantage Plan… When can I return to Original Medicare?

Toni:

I never should have listened to my brother who bragged about how his Medicare Advantage plan was a great way to save money and not have to spend so much on my Medicare supplement plan’s premium. I discovered that the eye doctor who was to perform surgery on my right eye in early January is not in this plan. I should have called his office before I signed up for the HMO plan.                                                                                                                                               Now my eye surgery is postponed since the doctor’s office is requesting that I return to Original Medicare to do the type of surgery that is needed. Can you explain how and when I can return to Original Medicare? I am glad I had not cancelled my Medicare Supplement Plan G even though the premium has increased. Signed…Christina from Phoenix, AZ

Hello Christina:

Readers, if you have discovered you made the wrong choice in selecting a Medicare Advantage (MA) Plan, Jan. 1 begins the 3-month period allowing you to change to a different Medicare Advantage Plan or return to Original Medicare. Your changes will take place on the first day of the following month. Christina, if you drop your MA Plan in January, then you will return to Original Medicare on Feb. 1.

The 2025 Medicare & You Handbook discusses on page 72, the changes that can be made to Medicare Advantage Plan during the period, called the Medicare Advantage Open Enrollment Period (MA OEP), which runs from Jan.1 through Mar. 31 each year.

During the MA OEP, a person can switch from one Medicare Advantage Plan to another Medicare Advantage Plan, or to Original Medicare with or without a Part D plan. The main difference between Medicare Advantage Open Enrollment Period (MA OEP) and Medicare Annual Enrollment Period (AEP) is who can use each one: Only individuals on a Medicare Advantage Plan can utilize the Medicare Advantage Open Enrollment Period.

A person may not disenroll from a Medicare Advantage plan or a Medicare Part D prescription drug plan after Mar. 31, because one is “locked in” from Apr. 1 to Dec. 31. One must wait until the next Medicare Annual Enrollment Period (AEP), which occurs annually from Oct.15 through Dec. 7 to change to a different plan or return to Original Medicare.

You made a smart choice, Christina, in not cancelling your Medicare Supplement because, due to your health issues, you may not be able to qualify for a new Medicare Supplement plan. Most Americans do not realize there is no special period to enroll in a Medicare Supplement like there is for Medicare Advantage Plans. One may change a Medicare Supplement any day of the year with qualifying medical underwriting questions.

Readers do not cancel your Medicare Supplement plan for the first few months that you are trying a Medicare Advantage plan just in case you need to return to Original Medicare during the MA OEP from Jan.1through Mar. 31.

During a Toni Says Medicare consultation, whether in person or by Zoom, we always advise Medicare clients to call all of their doctors and ask which Medicare Advantage plans the healthcare professional or facility accepts. Not doing that has caused this surgery postponement problem for you, Christina.

Readers, remember to always talk to the doctor’s office manager before you make any changes to your Medicare insurance and verify what MA Plans the office accept. Also be aware that doctors, specialists, and facilities can stop accepting a particular MA Plan at any time.

For assistance in disenrolling from a Medicare Advantage plan that does not fit your needs and finding a Medicare Supplement, call the Toni Says Medicare office at 832/519-8664 or email Medicare questions to info@tonisays.com.

Merry Christmas from Toni and the Toni Says Medicare Team!!