Medicare Advantage plans offer the same coverage as Original Medicare, and some offer additional benefits. Once you sign up, you can only drop or change a plan during certain enrollment periods.

You’ve done your research and decided to switch from Original Medicare to Medicare Advantage. But what happens if you change your mind or decide it’s not the right plan for you?

If you want to drop or change your Medicare Advantage plan, you have to wait for certain enrollment windows, similar to when you first signed up.

This article reviews each of these enrollment periods, including what type of plan you can choose during these times, and how to pick the best plan for your healthcare needs.

Enrollment windows for dropping or changing a Medicare Advantage plan

  • Initial enrollment period: a 7-month window that begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birthday.
  • Medicare open enrollment period: October 15 to December 7
  • Medicare Advantage open enrollment period: January 1 through March 31
  • Special enrollment period: Timing varies, as it occurs for only certain situations in your life, such as if you move to a new address.

While a lot of effort goes into making an initial decision on Medicare plans, you may need to switch for a variety of reasons.

Medicare Advantage (Part C) plans offer the same benefits as Original Medicare and, in some cases, added or optional services like Medicare Part D prescription coverage and supplemental insurance.

However, depending on your plan, you could discover drawbacks such as limited providers, added costs, and lack of coverage while traveling.

In addition, plans can change offerings, and sometimes, your needs may change as well. In this case, you may want to go back to your Original Medicare or switch to Part C plans. You may need to add or change your prescription plan, switch to a Medicare Advantage plan that covers different providers or services, or find a plan that covers a new location.

Some of the most common reasons for changing plans include:

  • you’ve moved
  • you’ve lost your current coverage
  • you have the chance to get coverage from another source, like an employer or union
  • Medicare ends its contract with your plan
  • your provider decides not to offer your plan any longer
  • you qualify for additional services, like Extra Help or a Special Needs Plan

The following sections go over each of the enrollment periods for Medicare Advantage.

You can sign up for Medicare Advantage when you’re first eligible for Medicare. You become eligible for Medicare on your 65th birthday, and you can sign up for the program over a span of 7 months (3 months before you turn 65, the month of your birthday, and 3 months after).

If you sign up during this period, this is when you can expect coverage to begin:

  • Enroll during the three months before your 65th birthday: Coverage begins the first day of the month of your birthday (for example, if your birthday is May 15, and you sign up in February, April, or March, your coverage will begin on May 1).
  • Enroll during your birthday month: Coverage will begin one month after you enroll.
  • Enroll within the 3 months after your birthday:If you enroll in Original Medicare the month you turn 65 or during the three months after, your coverage begins the following month.

If you choose a Medicare Advantage plan during initial enrollment, you can change to another Medicare Advantage plan or return to Original Medicare within the first 3 months of your coverage.

After you’ve signed up during initial enrollment, there are only a few times throughout the year when you can change or drop your Medicare Advantage coverage. These periods occur at the same time each year.

Medicare open enrollment | October 15 to December 7

This is the time each year that you can review your coverage and make changes if needed. During open enrollment, you can make changes to your original Medicare plan, sign up for Medicare Advantage or Medicare Part D, or switch from one Medicare Advantage plan to another.

Medicare Advantage open enrollment | January 1 to March 31

During this period, you can switch to another Medicare Advantage plan (with or without drug coverage) or drop your Medicare Advantage plan and go back to Original Medicare. You can also use this enrollment period to join a separate Medicare drug plan (Part D).

Enrolling in or changing plans during these specific periods can help you avoid penalties for late enrollment.

Special enrollment periods are available for situations that occur outside of your control, like having to move to an area your plan doesn’t serve. In these situations, Medicare allows you to make changes outside of the usual enrollment windows without penalty.

Special enrollment periods take effect when you need them, for example, if you’ve moved and your current Medicare Advantage plan doesn’t cover the new area where you live. In this case, if you tell your plan before you move, your special enrollment period will begin the month you move. If you tell them after you move, it will begin the month you tell your plan.

Special enrollment periods typically begin when you need them and last for about 2 months after the qualifying event. A few other examples of these qualifying events would be:

Once you’ve decided to drop or change your Medicare Advantage plan, the first step is to enroll in the new plan you’ve chosen. Do this by filling out an enrollment request with the new plan during an open or special enrollment period to avoid penalties.

After you’ve signed up with a new plan and your coverage begins, you’ll be automatically disenrolled from your previous plan.

If you’re leaving Medicare Advantage to return to Original Medicare, you can call 800-MEDICARE to resume Original Medicare services.

If you run into problems, you can contact the Social Security Administration, which runs the Medicare program, or your local SHIP (State Health Insurance Assistance Program).

There are many factors to consider when choosing a Medicare plan, and your needs or finances might change down the road. Weigh your options carefully at the beginning, keeping your current and future healthcare needs and budget in mind.

Medicare Advantage plans offer optional additional services but will cost more than Original Medicare. Some of the costs you pay upfront with Medicare Advantage may save you money in the long run, especially on extra services like:

If you go with a Medicare Advantage plan, you should also review the plan’s quality rating and whether your existing or preferred doctors and facilities are in-network. Compare plans carefully to find one that fits your specific needs.

You should also review your prescription drug plan options, considering which plans cover your medications. Each plan should outline cost ranges for various drugs. Make sure what you need is covered at a price you can afford.

Remember, switching from Medicare Advantage doesn’t just mean you have to go back to Original Medicare. You can always switch from one Medicare Advantage plan to another. You’re also able to change your prescription drug coverage as well.

Can a Medicare Advantage plan disenroll a member?

Reasons you could be disenrolled from your Medicare Advantage plan include if your plan is canceled, if you move to a new location, or if you don’t pay your monthly premium.

What is the 8-month rule for Medicare?

If you still have employer-based private insurance when you qualify, you get a special enrollment period to sign up for Medicare without having to pay a penalty. This lasts from the first month after your Initial Enrollment Period ends until no more than 8 months after your private coverage or your employment ends.

When can I switch from Medicare Advantage to Original Medicare?

You can switch from Medicare Advantage to Original Medicare during the Open Enrollment Period between October 15 and December 7 or during the Medicare Advantage Open Enrollment Period between January 1 and
March 31.

What is the grace period for Medicare Advantage plans?

If you miss your Medicare Advantage premium payment, you should receive a notice before you’re disenrolled. You typically receive a 2-month grace period during which you can still make your payment. This grace period starts on the first day of the first month in which the premium was missed.

Medicare Advantage plans expand on the services and coverage offered by original Medicare, but they may cost more.

If you’ve enrolled in a Medicare Advantage plan, you can switch Advantage plans or go back to Original Medicare during specific time periods.

To avoid penalties, you should switch or drop plans during open or annual enrollment periods or check to see if you qualify for a special enrollment period.