ArcaMax

Toni:

In August, my husband and I enrolled in a Medicare Supplement, which has not paid a medical claim because we were in a Medicare Advantage plan when we applied for the Medicare Supplement. We could not leave the Advantage plan and return to Original Medicare due to Medicare rules.

I was told that Medicare’s Open Enrollment is when Sonny and I can disenroll from this Advantage plan and return back to Medicare, but I do not know what to do.

Toni, can you please explain what we should do since Medicare’s enrollment period is beginning? Thank you.

—Leslie from New Orleans

Hello, Leslie:

The biggest no-no in the Medicare insurance world is when an insurance agent sells a Medicare beneficiary (which is what you and Sonny are) who has a Medicare Advantage plan a new Medicare Supplement without advising the client how to disenroll properly from their Medicare Advantage plan.

The proper time to disenroll from the Medicare Advantage plan that you and Sonny are currently enrolled in is, as you were told, during Medicare’s Open Enrollment Period (OEP), which in the past was called Medicare’s Annual Enrollment Period (AEP). The enrollment period has not changed and is still from October 15 to December 7.

For the two of you to return to Original Medicare and disenroll from your Medicare Advantage plan is very simple. All that you and Sonny have to do is visit www.medicare.gov after October 15 and enroll in the Medicare stand-alone Part D prescription drug plan that is right for you. The new Part D plan will begin January 1, and you will be disenrolled from the Advantage plan and enrolled into Original Medicare. Now the two of you can begin using the Medicare Supplement that you applied for in August because you will be on Original Medicare.

For those who already have either a stand-alone Medicare Prescription Drug (Part D) plan or Medicare Advantage plan, Medicare’s OEP is the time to make sure your drug plan or Advantage plan still meets your needs. Use www.medicare.gov to verify that your prescription drugs are covered in your 2026 Medicare Part D or Medicare Advantage Part D plan formulary. It is very important to verify what prescriptions are covered every year! If your prescriptions are not covered by your existing plan for 2026, you will have to pay 100% of that prescription cost out of pocket!

Changes that can be made during Medicare’s Open Enrollment Period (OEP) are as follows:

—Return to Original Medicare: Enroll in a stand-alone Medicare Part D Prescription Drug Plan. (Leslie, this is the Medicare OEP option for you and Sonny to begin using the Medicare Supplement you enrolled in this August.)

—Enroll in a Medicare Part D Prescription Drug Plan for your initial time or if this is a late enrollment.

—Change from one Medicare Part D Prescription Drug Plan to a new Medicare Part D Prescription Drug Plan.

—Enroll in a Medicare Advantage Plan with Prescription Drugs.

—Change from one Medicare Advantage Plan with or without Prescription Drug Plan to a new Medicare Advantage Plan.

—Return to Original Medicare with no Part D plan.

Reader alert: Please enroll in a Medicare Part D plan whether or not you are currently taking prescriptions. There is a Part D penalty for not enrolling in a Medicare Part D Prescription Drug Plan when you are first eligible. The penalty lasts for the rest of your Medicare life.

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Toni King is an author and columnist on Medicare, Social Security and long-term care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.

©2025 Toni King. Distributed by Tribune Content Agency, LLC.

Copyright 2025 Toni King, Distributed by Counterpoint Media