A 71-year-old woman attempted to leave her Medicare Advantage plan and return to Original Medicare, only to have the transition halted by three health questions on a Medigap application. The episode illustrates a structural feature of the Medicare market: the ability to disenroll from Advantage exists, but the supplemental coverage that makes Original Medicare financially predictable is not guaranteed once the initial enrollment window closes.
Federal rules allow Medicare Advantage enrollees to return to Original Medicare during two annual windows — the Annual Election Period from October 15 to December 7, and the Medicare Advantage Open Enrollment Period from January 1 to March 31. Disenrollment itself carries no CMS penalty. The complication arises when the enrollee seeks a Medigap policy to cover Original Medicare's cost-sharing. Outside of specific guaranteed-issue rights, Medigap insurers in most states may use medical underwriting to decide whether to sell a policy and at what price.