Is there a penalty for switching from Medicare Advantage back to Original Medicare?

Question

Mark Bilgere · Accepted Answer

There is no penalty for switching from Medicare Advantage to Traditional Medicare. There are some things to be aware of though. Remember, if your Advantage plan had drug coverage, you now need to add a stand a lone Part D Drug plan. Also, you can only make the switch during one of the approved enrollment periods.

Answered by Mark Bilgere on April 28, 2026

Broker Licensed in TX, AR, IN & LA, MN, NE & OK

Answered by Mark Bilgere Medicare Insurance Agent

Michelle Sparks · Answer

There is no penalty for switching back from Medicare Advantage to Original Medicare. However, there are several things you need to consider before doing so. Most important, you need to be aware that you will likely need to pass underwriting, which will consist of a medical review. In some cases, depending on the state, there are also anniversary or birthday rules, where you can switch without an underwriting requirement. Other major considerations are below: 

1) Original Medicare is a 80/20 plan with no stop gap. Therefore, if you have a chronic condition or a catastrophic health event, you could be responsible for very large medical bills. I recommend that you apply for a Medigap or Medicare Supplement plan that would pick up the majority of the 20% covered costs. This however, is an additional premium on top of the Part B premium ($202.90) that you would already be paying monthly. 
2) If you move to Original Medicare and a Supplement, you will also be responsible for enrolling in a stand alone Part D plan to cover your prescription drug costs. This is also another monthly premium (average premium is approximately $45 monthly).
3) Your Medicare Advantage plan also bundles dental, hearing and vision. Original Medicare and Supplements do not cover these ancillary services. If you want coverage for dental, vision or hearing, you would also need to consider a rider to your supplement, or a stand alone plan. These will run between $30-$80 monthly. 
4) The timing of this change is also an important consideration. You can change to Original Medicare from a Medicare Advantage Plan during the annual enrollment period (AEP) 10/15-12/7 (change would be effective with January 1), or you can change during the Open enrollment Period (OEP) January- March (change would be effective the following month). 

If this is something that you are seriously considering, I recommend that you reach out to a local Medicare broker that can walk you through each of these considerations.

Sherry Rose · Answer

No there is no penalty for switching back to Original Medicare, However please call our office for advise.

Andrew Zurbuch, MBA · Answer

No, there is no penalty. Call 1800Medicare to change back to Original Medicare. Generally the Annual Medicare Open Enrollment Period is a good time to do it. Thank you.

Lloyd Griffin · Answer

It's not about a penalty yet under the right conditions for switching. Annual open enrollment or a Special Enrollment Period and Medicare Advantage Open Enrollment Period.

Carol Thompson · Answer

There is no penalty that I am aware of if you switch back to original but you may have to pay $260ish to meet a  initial deductible.

Mark Boone · Answer

Switching from a Medicare Advantage plans back to original Medicare is easy, but you must enroll in a Prescription Drug Plan (Part D) and you can only do that during the Annual Enrollment Period (AEP) or during a Special Enrollment Period (SEP) otherwise you may be subject to a late enrollment penalty for each month you do not have Part D coverage

Answered by Mark Boone on May 26, 2026

Agent Licensed in MN, FL, MI & NC, OH, SC & VA

Answered by Mark Boone Medicare Insurance Agent

Dean Chiapetto · Answer

You have certain times of year that you can switch back to Original Medicare. Every year you can go back to Original Medicare during the Annual Election Period, Oct 15 - Dec 7 and it will start Jan 1. There is another period from Jan 1 - Mar 30. If this was your 1st time in an Advantage plan you have 12 months to go back to Original Medicare. It is important to have a local broker to go over your options.
Brokers Make A Difference.

Amy Jones · Answer

No. You just have to do it during the Annual Enrollment Period or when you have a valid Special Election period.

William Murray · Answer

There should be no penalty I can think of for a switch such as that, unless you are already being assessed a penalty or if you go 63 or more days without a prescription drug plan.

Seyed Kamarei · Answer

late enrollment penalty and Most Medicare Advantage plans automatically include Part D while original Medicare does not. If you switch from Medicare Advantage to original Medicare and do not choose a Part D plan within 63 days, you may incur a late enrollment penalty and / or higher premiums for it./ or higher premiums for it.

Answered by Seyed Kamarei on April 28, 2026

Agent Licensed in IL

Answered by Seyed Kamarei Medicare Insurance Agent

Is there a penalty for switching from Medicare Advantage back to Original Medicare?

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Is there a penalty for switching from Medicare Advantage back to Original Medicare?

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