Switching from a Medicare Advantage Plan back to Original Medicare

Can you go back to Original Medicare from an Advantage Plan?

It is possible to switch from your Original Medicare plan to an Advantage Plan, but what is the difference between Original Medicare and a Medicare Advantage Plan? Why might one want to make the switch?

Original Medicare 

The federal government administers Original Medicare. There are two parts to the program: Medicare Part A and Part B. Medicare Part A is known as hospital insurance. It covers eligible costs for your care as an inpatient in a hospital or nursing facility and may cover hospice care. Part B is your medicare insurance that generally covers outpatient services such as doctors’ visits, home health care, and certain preventive services. 

Under Original Medicare, you can receive care from any doctor, hospital, or other providers who accept Medicare. When receiving Original Medicare, you often have to pay copayments or coinsurance.

Original Medicare does not include coverage for prescription drugs, except for those that must be administered by a medical professional. 

Medicare Advantage

The Medicare Advantage program is provided by private insurance companies approved by Medicare to offer benefits. This means that premiums can differ depending on the plan you choose because the insurance company sets all premiums. You will also continue to pay your Part B premium and any premium your Advantage Plan requires.

Medicare Advantage plans are required to provide the same coverage as Original Medicare but can provide additional benefits to their members. Many Medicare Advantage plans include Medicare Part D prescription drug coverage, so you receive all of your Medicare benefits in one convenient plan. Additionally, many offer coverage for routine vision, dental and hearing services not provided with Original Medicare. 

Medicare Advantage plans can set their own rules and guidelines for members. For example, they determine the number of copayments and coinsurance you will pay for covered services. They decide the number of copayments and coinsurance you will pay for covered services. They may require you to choose from a list of selected providers for your health care.

Once you reach a set limit of out-of-pocket expenses, you pay nothing for your covered healthcare costs. This limit varies from plan to plan and can change each year. 

If you realize your Medicare Advantage plan is not for you, making the switch should be quite straightforward. 

For any questions, call Temmen Insurance at 417-633-7200.

Recent Posts