Step‑By‑Step Guide to Moving From Original Medicare to a Medicare Advantage Plan

If you’re on Original Medicare (Part A and Part B) and want one plan that can bundle medical, drug, and extra benefits, switching to a Medicare Advantage (Part C) plan can be a practical move—if you time it right and understand what you’re giving up and gaining.

1. Confirm You’re Eligible to Switch

You can generally join a Medicare Advantage plan if:

• You have Medicare Part A and Part B active.
• You live in the plan’s service area.
• You’re not enrolled in Medicare Advantage already (you’ll be switched from Original when you join).

Most people switch during:

• Annual Enrollment Period (AEP): October 15–December 7
  Coverage with your new Medicare Advantage plan typically starts January 1.
• Medicare Advantage Open Enrollment Period: January 1–March 31
  Lets you switch Medicare Advantage plans or go back to Original Medicare.
• Certain Special Enrollment Periods (SEPs) if you have qualifying life events like moving out of your plan’s area or losing other coverage.

2. Compare Medicare Advantage Plans to Your Current Coverage

Before you leave Original Medicare (and any Medigap and Part D plans), review:

• Provider networks: Are your doctors, specialists, and preferred hospitals in‑network?
• Drug coverage: Check the plan’s formulary to confirm your medications are covered and at what tier.
• Costs: Look at monthly premiums, copays, coinsurance, and the annual out‑of‑pocket maximum.
• Extra benefits: Some plans may include vision, dental, hearing, or fitness benefits not covered by Original Medicare.
• Referrals and rules: Understand prior authorization, referral requirements, and coverage rules for out‑of‑network care.

Use the same set of priorities—providers, drugs, and total annual costs—to compare plans side by side.

3. Enroll in a Medicare Advantage Plan

Once you’ve chosen a plan, you can enroll by:

• Calling the plan directly.
• Calling Medicare.
• Using the official Medicare enrollment tools.

You’ll need your Medicare card (with your Part A and Part B start dates and Medicare number). When you enroll, you’re authorizing the plan to coordinate the switch from Original Medicare.

Your coverage under the new Medicare Advantage plan begins on the plan’s effective date (often January 1 if you enroll during AEP).

4. Understand What Happens to Other Coverage

When your Medicare Advantage plan starts:

• Your Original Medicare coverage remains in the background, but the Medicare Advantage plan manages your benefits.
• Your Medigap (Medicare Supplement) policy cannot be used with a Medicare Advantage plan. In most cases, you’ll need to drop the Medigap policy.
• If your chosen Medicare Advantage plan includes drug coverage (MAPD), you generally will be disenrolled from a stand‑alone Part D plan automatically.
• If your Medicare Advantage plan does not include drug coverage, make sure you understand how you will get prescription coverage and whether you can or should keep a Part D plan.

Be aware: If you later want to switch back to Original Medicare, getting Medigap again may not be guaranteed and could require medical underwriting except in specific protected situations.

5. Review Your New Plan as Soon as It Starts

After your new plan takes effect:

• Confirm your ID card, Summary of Benefits, and provider directory.
• Schedule an annual wellness visit if available.
• Double‑check pharmacies and drug copays with your new coverage.

Switching from Original Medicare to Medicare Advantage can streamline coverage and potentially lower some costs, but it changes how your care is managed. Knowing the enrollment windows, comparing plans carefully, and understanding the impact on Medigap and drug coverage helps ensure the move works for both your health needs and your budget.