If you are thinking about switching from a Medicare Advantage plan to traditional Medicare, it is important that you know when the right time for doing so would be. There are certain times of the year when this is possible, and if you miss them, delays or problems might arise. Here is what you should know regarding the main dates and procedures for making a successful move from Medicare Advantage to classic Medicare.
Medicare Open Enrollment Period: October 15 to December 7
The first chance you have to switch from your Medicare Advantage plan to traditional Medicare is during the Medicare Open Enrollment Period. Every year, this enrollment period lasts from October 15th until December 7th.
Keynote: If you make the switch during these dates, then on January 1 of the following year your new traditional Medicare coverage will be effective.
If traditional Medicare suits you better than anything else, then you must act within that specific time frame. This is your first opportunity to switch due to coverage, flexibility, or even out-of-pocket expenses. If so desired, you should start by contacting the present Medicare Advantage plan for cancellation of the subscription. And later on, proceed by calling 1-800-MEDICARE (1-800-633-4227) to complete everything else involved in switching over.
Medicare Advantage Open Enrollment Period: January 1 to March 31
In case you have missed out on the Medicare Open Enrollment period, do not worry—you are still given another chance to swap. Medicare Advantage Open Enrollment Period lasts from January 1 to March 31. During this phase, someone can switch back from a Medicare Advantage plan to traditional Medicare coverage. If a person chooses this option during such times, their coverage will take effect on the first day of the month after the request is received by their previous provider.
The secondary window allows for some leeway if adjustments were not done in autumn enrollment time. However, time is of utmost importance because once we reach March 31, it would mean waiting till next year’s enrollment unless one qualifies for a special enrollment period.
Don’t Forget About Prescription Drug Coverage
As you change over to usual Medicare, you might need to consider the aspect of medication coverage as well. Many Medicare Advantage plans have these drugs inbuilt but not in traditional Medicare. Therefore, you must register with an independent Prescription Drug Plan (PDP) to keep getting your prescriptions.
If you do not register for a PDP while changing back to traditional Medicare and later try to enroll, there are chances that you may incur a late enrollment penalty. This is a typical misconception but could easily be avoided by simply registering with a PDP when making this change.
Consider Medigap for Supplemental Coverage
Another thing to consider when switching back to traditional Medicare is the acquisition of a Medicare supplemental insurance policy called Medigap.
Medigap covers some of the additional expenses that are not included in traditional Medicare, such as copayments, coinsurance, and deductibles.
Nevertheless, there’s an exception: if you have been on Medicare Advantage for some time already, it is possible that Medigap insurers may not be obligated to sell you a policy unless certain medical underwriting requirements are fulfilled. This means that before being approved for a policy, your health may be assessed. It would be advisable to contact several Medigap insurers directly to find out whether you can purchase this kind of insurance and know how much it costs.
Final Thoughts
The change from Original Medicare to Medicare Advantage program calls for crucial due dates and other factors. It is essential to know what steps to take when moving for alternative coverage like a prescription drug plan, Medigap policy, or anything else.
If you are aware of these important dates, whether it is during the Medicare Open Enrollment Period or the Medicare Advantage Open Enrollment Period, it will help you a lot in avoiding risks such as penalties due to a lack of information regarding healthcare transformation.
To know more about Medicare, read: Medicare changes in 2025: this will be the limit on drug prices for its beneficiaries, New Medicare rules for 2025 explained: These are the Major changes for Part D and When will Medicare Part B and Part D Premiums for 2025 be announced?