Medicare Advantage Disenrollment Periods

Medicare Advantage (Part C) plans are a popular choice for many people eligible for Medicare. These all-in-one plans often include extra benefits like dental, vision, or hearing coverage, and may have lower monthly premiums than other Medicare options. But what happens when a plan no longer meets your needs?

That’s where Medicare Advantage disenrollment periods come in.

If you’re considering switching plans or returning to Original Medicare, it’s important to know when and how you can make that change. This article breaks down the different disenrollment opportunities, the rules that apply to each, and how to avoid common pitfalls when making changes to your Medicare coverage.

Medicare Advantage Open Enrollment Period (MA OEP)

The Medicare Advantage Open Enrollment Period (January 1 through March 31) is designed specifically for people who are already enrolled in a Medicare Advantage plan and want to make a change. During this time, you have two options:

• Switch to a different Medicare Advantage plan

• Drop your Medicare Advantage plan and return to Original Medicare (you can also join a Part D prescription drug plan at this time)

You can only make one change during this period. So, if you switch plans or return to Original Medicare, that’s your move for the year unless you qualify for another enrollment period.

It’s important to note that this window is not for people on Original Medicare who want to join a Medicare Advantage plan. That switch can only be made during the Annual Enrollment Period or if you qualify for a Special Enrollment Period. We’ll talk about those enrollment periods next!

Annual Enrollment Period (AEP)

The Annual Enrollment Period (sometimes called the Medicare Fall Open Enrollment) is the most well-known window for making Medicare changes. It runs from October 15 to December 7 every year. During AEP, you can:

• Switch from a Medicare Advantage plan back to Original Medicare

• Switch from Original Medicare to a Medicare Advantage plan

• Change from one Medicare Advantage plan to another

• Join, drop, or change a standalone Part D prescription drug plan

If you make a change during AEP, your new coverage will take effect on January 1 of the following year. This is the ideal time to review your plan for the upcoming year, especially since Medicare Advantage plans can change each year in terms of coverage, networks, and drug formularies.

Special Enrollment Periods (SEPs)

Sometimes unexpected life events make it necessary to change your Medicare coverage. Special Enrollment Periods give you that flexibility. These periods are triggered by specific circumstances, such as moving out of your plan’s service area, losing other health coverage like an employer-sponsored plan, or your Medicare Advantage plan ending or being terminated. Other events (like gaining or losing eligibility for Medicaid or Extra Help) can also qualify you for a SEP.

Depending on the qualifying event, your SEP usually lasts two to three months. During this time, you can switch to another Medicare Advantage plan or return to Original Medicare. You can also join or change a standalone Part D drug plan. Because the timelines and rules can vary, it’s essential to act quickly and seek help if you think you might be eligible.

Trial Right Period: A Special Protection for New Enrollees

If you're enrolling in a Medicare Advantage plan for the first time, you may have a built-in safety net known as the Trial Right. This special protection allows you to test out a Medicare Advantage plan for up to 12 months. If you decide the plan isn’t meeting your needs, you have the right to return to Original Medicare within that one-year window.

Even more importantly, this trial right often includes a guaranteed issue right for a Medigap (Medicare Supplement) plan. That means you can get a Medigap policy without going through medical underwriting—something that’s not always possible later. This is a one-time protection and only applies the first time you ever join a Medicare Advantage plan, so it’s important to understand the timing and rules before switching.

How Voluntary Disenrollment Works

If you’ve decided to leave your Medicare Advantage plan and you qualify for a valid disenrollment period, there are a few ways to initiate the process. You can call Medicare directly at 1-800-MEDICARE, submit a disenrollment request to your current plan, or simply enroll in a new plan that will automatically cancel the old one. Many people also choose to work with a licensed Medicare agent who can help ensure the process goes smoothly.

The timing of your disenrollment taking effect will depend on the period you’re using. If you make changes during AEP, your new coverage will begin on January 1. If you disenroll during the Medicare Advantage Open Enrollment Period, your new plan or return to Original Medicare typically starts the first day of the month after your request is processed. Special Enrollment Periods have their own effective dates, which can vary based on the qualifying event.

Important Considerations Before You Disenroll

Switching out of a Medicare Advantage plan can make sense in certain cases—but there are a few things you should consider first.

1. Part D Coverage

If you’re going back to Original Medicare, you’ll need a standalone Part D plan for prescription drug coverage. If you miss this step, you could go without medication coverage and risk paying a late enrollment penalty down the line.

2. Medigap Enrollment Rules

While you can return to Original Medicare during certain periods, enrolling in a Medigap plan isn’t always guaranteed. Outside of your initial enrollment period or trial right, you might be subject to medical underwriting, and you could be denied based on health history.

3. Provider Access

One of the main reasons people leave Medicare Advantage is to regain broader access to doctors and hospitals. With Original Medicare, you can see any provider nationwide who accepts Medicare. However, you should always double-check before making the switch.

4. Costs

Don’t assume that switching will automatically save you money. Original Medicare + Medigap + Part D can have higher monthly premiums than Medicare Advantage. But you might have fewer out-of-pocket costs and more predictable expenses. Weigh the full picture before making your decision.

Common Reasons People Disenroll from Medicare Advantage

While Medicare Advantage works well for many, there are some common reasons people choose to leave their plan. These include unexpected out-of-pocket costs, changes to provider networks, denial of certain services or medications, and frustration with needing referrals or prior authorizations. Some people also disenroll after moving to a new area or simply because they prefer the freedom that comes with Original Medicare and a Medigap policy.

Get Help from Local Medicare Specialists

At Local Medicare Specialists, we understand that your needs may change over time—and your Medicare coverage should change with them. Whether you’re thinking about switching plans, returning to Original Medicare, or exploring Medigap and Part D options, we’re here to help.

Our licensed agents offer free consultations, plan reviews, and personalized advice to help you make the right choice. If you’re unsure whether you qualify for a disenrollment period or what your next steps should be, reach out today. We’ll walk you through the process and make sure you’re fully informed every step of the way.