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

Question

Michelle Sparks · Accepted 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 an 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.

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.

Brokers Make A Difference.

Mark Bilgere · 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-alone 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

Mark Boone · Answer

Switching from a Medicare Advantage plan 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

Elisa Peinado · Answer

The answer is No. Penalties are only applied if you did not enroll in Medicare when you became eligible or if you did not have creditable coverage through an employer when you aged in to Medicare.

However, switching from Medicare Advantage to Original Medicare is only offered during the Annual Enrollment period, October 15th - December 7th or during a Special enrollment period like a move.

If you need help, please contact me.

Amy Jones · Answer

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

Vincent Ronzano · Answer

There is no penalty for dropping a Medicare Advantage plan and going back to Medicare. Call 1-800-MEDICARE to complete the task.

Michael Murray · Answer

There is no penalty; you just need to be aware of the costs that will change for your coverages, such as going to the doctor's office will now be a charge of 20% of the cost per the visit. Original Medicare is set up differently than private insurance; know the changes before you make that decision to go back to Original Medicare.

Answered by Michael Murray on July 21, 2026

Agent Licensed in NC, SC & TN

Answered by Michael Murray Medicare Insurance Agent

Seyed Kamarei · Answer

Late enrollment penalty: 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.

Answered by Seyed Kamarei on April 28, 2026

Agent Licensed in IL

Answered by Seyed Kamarei Medicare Insurance Agent

Andrew Zurbuch, MBA · Answer

No, there is no penalty. Call 1-800-MEDICARE to change back to Original Medicare. Generally, the Annual Medicare Open Enrollment Period is a good time to do it. Thank you.

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.

Nick Mangini · Answer

There is no penalty for switching back to Original Medicare as primary. However, you will need to shop for a Medicare Supplement (Medigap) plan to help cover your out-of-pocket costs associated with Original Medicare. We can help you shop your plan options!

Answered by Nick Mangini on October 19, 2026

Broker Licensed in FL, AL, AZ & 32 other states

Answered by Nick Mangini Medicare Insurance Agent

Mike Odle · Answer

There is no penalty from switching from Medicare advantage to original Medicare. Before doing this please consider all the out-of-pocket associated with original Medicare and compare it to how a Medicare advantage plan mitigates a great deal of it.

Answered by Mike Odle on October 26, 2026

Broker Licensed in IN & IL

Answered by Mike Odle Medicare Insurance Agent

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 an initial deductible.

Sherry Rose · Answer

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

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.