There are set times during the year when people can change their Medicare coverage. You can switch from Original Medicare to Medicare Advantage during one of these Medicare enrollment periods.

Original Medicare refers to Part A (hospital insurance) and Part B (medical insurance). It is administered by the federal government and provides coverage for a wide range of services with healthcare providers across the United States.

Medicare Advantage (Part C) is an alternative to Original Medicare. Private insurance companies offer these plans. They offer the same level of coverage as Original Medicare but include expanded benefits, such as drug coverage and dental, hearing, and vision care.

If you’re currently enrolled in Original Medicare, you may switch to a Medicare Advantage during the Medicare open enrollment period (OEP).

This article discusses when and how to switch from Original Medicare to Medicare Advantage, along with the potential benefits and drawbacks of Medicare Advantage plans.

Medicare open enrollment is the primary period when someone with Original Medicare can switch to Medicare Advantage. The OEP runs from October 15 to December 7 each year.

During the OEP, Medicare beneficiaries can make a wide range of changes to their coverage, including joining, dropping, or switching Original Medicare, Medicare Advantage, and Part D prescription drug plans.

The Medicare Advantage open enrollment period (MA OEP) is a separate period that runs from January 1 to March 31 each year. During MA OEP, people who already have Medicare Advantage plans can switch plans or return to Original Medicare. However, people with Original Medicare cannot join Medicare Advantage during the MA OEP.

The first step in switching from Original Medicare to Medicare Advantage is finding the right plan for you. Plan options vary by location, so you’ll need to search by ZIP code to learn what’s available.

You could also speak with a licensed insurance agent or your local State Health Insurance Assistance Program (SHIP) for guidance.

Consider both your health needs and financial resources when selecting a plan. Do you take specific medications? Do you need coverage benefits for things like dental and vision care? How do the plan’s costs align with your financial needs and expected healthcare costs?

Once you’ve found a plan you like, you have a couple of options for how to join it. If you’ve searched for the plan on Medicare.gov, you can click the “Enroll” button and follow the steps to get started.

Alternatively, you may reach out to the insurance carrier directly. You can typically do so online or by phone, and a representative will help you through the process.

There are benefits and drawbacks to Medicare Advantage plans. These plans won’t make sense for all individuals.

Consider the following pros and cons when deciding whether to switch from Original Medicare to Medicare Advantage. However, note that different plans may have different benefits, so these factors may not apply in all situations.

Potential pros of Medicare Advantage plans include:

  • additional coverage, such as vision, dental, and hearing care
  • extra benefits, such as fitness plans, over-the-counter (OTC) cards, transportation assistance, telehealth services
  • prescription drug coverage
  • out-of-pocket spending limits

Potential cons of Medicare Advantage plans include:

  • limited provider networks
  • no option for supplemental coverage (Medigap)
  • requiring prior authorization before procedures

Yes, you can switch from Original Medicare to Medicare Advantage and vice versa. To do so, you’ll need to wait for the correct Medicare enrollment period unless you qualify for a special enrollment period (SEP).

SEPs allow people who have experienced life changes that affect their insurance coverage to enroll in Medicare in a timely fashion.

No, there is no penalty for switching from Original Medicare to Medicare Advantage.

Medicare has certain penalties for late enrollment, but these do not apply when switching between Original Medicare and Medicare Advantage.

You can switch from Original Medicare to Medicare Advantage during the open enrollment period (OEP), which is from October 15 to December 7 each year.

Prior to switching, it’s important to consider your health and financial needs and search for a plan that meets your requirements.

For free, unbiased health insurance counseling, consider speaking with a representative from your local SHIP.