Switching from Medicare Advantage to Medicare with Medicare Supplement

Medicare beneficiaries can get their Medicare Part A and Part B benefits through Original Medicare or Medicare Advantage. Medicare Advantage is a type of health plan offered by a private insurance company that contracts with the federal government to provide enrollees with Medicare Parts A and B benefits. Medicare Advantage plans operate within certain geographic areas and may limit coverage to certain medical provider networks.¹

"The Centers for Medicare and Medicaid Services determines when a person can switch from Medicare Advantage to Medicare Supplement insurance."

Those who get their benefits through Original Medicare are eligible to purchase Medicare Supplement insurance, also known as Medigap.² A Medicare Supplement policy helps cover some of the out-of-pocket expenses Original Medicare does not pay. Medicare Supplement coverage is not limited to a certain region of the country or to a group of providers.³ You can receive care from any provider in the country who accepts Medicare.

A brief comparison of Medicare Advantage and Medicare Supplement is shown below.^{3, 4}

The Centers for Medicare and Medicaid Services determines when a person can switch from Medicare Advantage to Medicare Supplement insurance.⁵

Medicare Initial Election Period (IEP)

If a person enrolls in Medicare Advantage when they first become eligible for Medicare, they can switch to Original Medicare and apply for a Medicare Supplement insurance policy within the first three months of their enrollment plan.

Medicare Annual Enrollment Period (AEP)

This is the time of year when Medicare beneficiaries can make changes to their Medicare coverage for the following year. It may also be referred to as the Annual Enrollment Period. This period runs annually from October 15 through December 7. Changes will take effect on January 1 of the next year. During this enrollment period, you can:

• Join, drop, or switch to another Medicare Advantage Plan (or add or drop drug coverage)
• Join a Medicare Advantage Plan or switch from a Medicare Advantage Plan to Original Medicare
• Once you switch to Original Medicare, you are eligible to apply for a Medicare Supplement insurance policy

Medicare Advantage Open Enrollment Period (MA OEP)

If you’re already enrolled in a Medicare Advantage Plan, the MA Open Enrollment Period runs annually from January 1 through March 31.

During MA OEP you can:

• Switch to another Medicare Advantage Plan
• Drop your Medicare Advantage Plan and return to Original Medicare; If you choose to do this, you will be able to join a Medicare drug plan (Part D)
• Once you switch to Original Medicare, you are eligible to apply for a Medicare Supplement plan6

Special Enrollment Period (SEP)

A Special Enrollment Period (SEP) is where a qualifying event gives you the chance to make changes to your Medicare Advantage outside the IEP, AEP or OEP.⁷

Examples of a qualifying event may be:

• Moving to a new area that is outside your plan’s service area
  • If you are in a Medicare Advantage plan and you move outside your Medicare Advantage plan’s service area, you can return to Original Medicare and apply for a Medicare Supplement plan.
• You lose your current Medicare Advantage coverage
• Your Medicare Advantage plan changes its contract with Medicare

If you are considering disenrollment from a Medicare Advantage plan, outside the set enrollment periods, contact the local office of your State Health Information Assistance Program (SHIP) or call Medicare at 1-800-Medicare for further information and assistance.⁸

Sources:

1. Medical News Today, https://www.medicalnewstoday.com/articles/can-i-switch-from-medicare-advantage-to-Medicare Supplement#when-to-switch, Updated March 24, 2021.
2. Medicare.gov, https://www.medicare.gov/health-drug-plans/Medicare Supplement/basics/how-Medicare Supplement-works, Accessed 2024.
3. Medicare and You Handbook 2024, https://www.medicare.gov/publications/10050-Medicare-and-You.pdf, Accessed 2024.
4. Forbes Health, https://www.forbes.com/health/medicare/medicare-advantage-vs-medicare-supplement, Updated May 20, 2024.
5. CMS.gov, https://www.cms.gov/priorities/key-initiatives/medicare-open-enrollment-partner-resources,  Accessed 2024.
6. KFF-Medicare, https://www.kff.org/medicare/issue-brief/what-to-know-about-the-medicare-open-enrollment-period-and-medicare-coverage-options, Published September 18, 2023.
7. Medicare.gov, Exceptional Circumstances, Accessed 2024.
8. SHIP, https://www.shiphelp.org/, Accessed 2024.