Can you switch back to original Medicare?

Yes, you can switch back to Original Medicare from a Medicare Advantage (MA) plan during specific times, primarily the Annual Enrollment Period (Oct 15-Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1-Mar 31), allowing you to disenroll from your MA plan and rejoin Original Medicare, often with a separate Part D drug plan, and consider a Medigap policy. Special Enrollment Periods (SEPs) also allow switches if you move out of your plan's service area or face other qualifying life events.

Is there a penalty for switching back to original Medicare?

There's no direct penalty for switching from Medicare Advantage (MA) to Original Medicare (OM), but you must enroll in a standalone Part D drug plan within 63 days of leaving your MA plan (if it included drug coverage) to avoid a lifetime late enrollment penalty for Part D, and you might face higher Medigap costs due to underwriting if you don't have guaranteed issue rights. You can switch during Annual Enrollment (Oct 15–Dec 7) or MA Open Enrollment (Jan 1–Mar 31). 

Can I drop my Medicare Advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage (MA) plan and return to Original Medicare, typically during the Annual Enrollment Period (AEP) (Oct 15–Dec 7) or the MA Open Enrollment Period (OEP) (Jan 1–Mar 31), though you may qualify for a Special Enrollment Period (SEP) if you move or have other qualifying life events, but be aware you'll need to get a Part D plan and might want a Medigap plan to help with costs. 

When can you return to original Medicare?

You can leave a Medicare Advantage plan and return to Original Medicare. The two times you can do this are during the Medicare Advantage Open Enrollment Period (January 1–March 31) or the Annual Election Period (October 15–December 7).

Why do people switch back to original Medicare?

However, cost alone was not a driver of plan switching. Instead, factors such as poor access to care, low quality, low plan star ratings and less generous fringe benefits played a more significant role in the decision to leave.

Can You Switch From Medicare Advantage to Original Medicare? | Medicare Made Simple Guide News

What is the downside of original Medicare?

The main disadvantages of Original Medicare (Parts A & B) are that it doesn't cover routine dental, vision, hearing, or most long-term care, lacks an out-of-pocket maximum (leading to potentially unlimited costs), and requires purchasing separate Part D (drugs) and Medigap (supplemental) plans for comprehensive coverage, adding extra premiums and complexity.
 

What is the 7 month rule for Medicare?

This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

How much does original Medicare cost per month?

Original Medicare (Parts A & B) costs vary, but for 2026, most people pay $0 for Part A (Hospital) and $202.90 for the standard Part B (Medical) premium monthly, with higher income earners paying more for Part B. You might pay premiums for Part A if you didn't work 10 years, and higher Part B costs (IRMAA) if your income is above a certain threshold. 

Why are people opting out of Medicare Advantage plans?

People are leaving Medicare Advantage (MA) plans due to difficulty accessing care (like provider network limits, prior authorizations), dissatisfaction with care quality, issues with plan generosity, and challenges with specific plans, especially as their health needs grow, often leading them back to Original Medicare for broader choice but sometimes finding it hard to switch. Healthier individuals might join for perks, but sicker enrollees often face network restrictions, approval hurdles, and poor experiences, prompting disenrollment, notes KFF and ElderLawAnswers. 

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

How do I enroll in Original Medicare?

To enroll in Original Medicare (Parts A & B), you typically sign up via the Social Security Administration (SSA) website, by contacting them directly, or by applying when you first become eligible around age 65 or after 24 months of disability, though some get it automatically; you'll need personal info, SSN, and health/work history to sign up during enrollment periods like your Initial Enrollment Period (IEP). 

How do I cancel my Medicare Advantage and go back to original Medicare?

To cancel your Medicare Advantage (MA) plan and return to Original Medicare, you must disenroll during the Annual Enrollment Period (Oct 15–Dec 7) or the MA Open Enrollment Period (Jan 1–Mar 31), or qualify for a Special Enrollment Period (SEP) like moving out of your plan's area, then enroll in a standalone Part D drug plan (which cancels MA) and consider a Medigap plan for better cost coverage. Contact your MA plan or call 1-800-MEDICARE to start the disenrollment process and then sign up for a Part D plan to get Original Medicare coverage. 

Does everyone have to pay $170 a month for Medicare?

If you don't get premium-free Part A, you pay up to $565 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($202.90 in 2026).

Is original Medicare better than an advantage plan?

Neither Original Medicare nor Medicare Advantage (MA) is inherently "better"; it depends on your health, budget, and lifestyle, as Original Medicare offers broad doctor choice but needs Medigap for extras/costs, while MA plans bundle benefits (dental, vision, drugs) with an all-in-one approach but use provider networks and have yearly out-of-pocket limits, making them great for predictable costs but limiting flexibility. 

What are the 5 things Medicare doesn't cover?

Medicare generally doesn't cover long-term care, most dental care, routine vision services (like glasses), hearing aids/fittings, and cosmetic surgery, though it does provide strong coverage for hospital and doctor services; you can often get coverage for these gaps through Medicare Advantage (Part C) or supplemental plans. 

What is the 3 month rule for Medicare?

Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)

What states have the worst Medicare Advantage plans?

States often cited for weaker Medicare Advantage performance include Louisiana, Mississippi, Kentucky, West Virginia, and Florida, due to challenges with care access, provider shortages, and quality issues like higher rates of avoidable hospitalizations and inappropriate medication prescriptions, though specific rankings vary by report and focus (e.g., satisfaction vs. overall system). Other states like New York, California, Texas, and Michigan appear on lists for low member satisfaction with specific plans, not necessarily the whole state's system. 

How to lower Medicare premiums?

To lower Medicare premiums, report income drops from life events like retirement (Form SSA-44), apply for low-income help like Extra Help or Medicaid, use HSA funds for premiums, deduct premiums from taxes, switch to a cheaper Medicare Advantage or Supplement plan, or check if you qualify for Medicare Savings Programs (MSPs) through your state. 

Does Medicare cover 100% of hospital bills?

No, Original Medicare (Part A & B) does not cover 100% of hospital bills; beneficiaries pay deductibles, coinsurance, and copays, but you can get full coverage by adding Medicare Supplement (Medigap) plans or choosing a Medicare Advantage plan. Part A covers the first 60 days of a hospital stay (after a deductible), but after that, you pay daily coinsurance, and there's no limit on your total costs unless you have supplemental coverage.
 

Do I really need supplemental insurance with Medicare?

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

Is there a penalty to switch from Medicare Advantage to original Medicare?

No, there's no direct penalty for switching from Medicare Advantage (Part C) back to Original Medicare (Parts A & B), but you risk significant issues: losing drug coverage (Part D penalty if you don't enroll in a separate plan) and potentially being denied or paying much more for a Medigap supplement due to medical underwriting after your initial guarantee period ends. You must switch during specific enrollment periods (Annual Election Period: Oct 15-Dec 7, or MA Open Enrollment: Jan 1-Mar 31). 

Is Medicare going to change in 2025?

Medicare Part B Premium and Deductible

The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, an increase of $17 from the annual deductible of $240 in 2024.

At what age do you stop paying Medicare premiums?

Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. See Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.