If you’ve spent the last year realizing that Medicare Advantage isn’t working for you — prior authorization denials, limited networks, surprise bills — you’re not alone. Thousands of Arizona seniors make the switch back to Original Medicare every year. In this guide, you’ll learn exactly how to switch from Medicare Advantage to Original Medicare, what windows are available, and what to watch out for.
Why People Switch from Medicare Advantage to Original Medicare
The most common reasons I hear from clients who want to switch from Medicare Advantage to Original Medicare:
Their doctor left the plan’s network
Prior authorization delays for procedures or specialists
Moving to a different part of Arizona or another state
Wanting access to Mayo Clinic or a major specialty hospital
High out-of-pocket costs after a serious illness
The plan’s benefits changed significantly at renewal
When Can You Switch from Medicare Advantage to Original Medicare?
There are two main windows to switch from Medicare Advantage to Original Medicare. Missing these windows means waiting until the next opportunity.
Medicare Advantage Open Enrollment Period (MA OEP)
January 1 – March 31 every year. During this window you can switch from one Medicare Advantage plan to another, or drop Medicare Advantage entirely and return to Original Medicare. Coverage changes take effect the first of the following month.
Annual Enrollment Period (AEP)
October 15 – December 7 every year. This is the main Medicare enrollment window. You can drop your Medicare Advantage plan and return to Original Medicare, with changes taking effect January 1. According to Medicare.gov, this is the primary window for making coverage changes.
The One-Way Door Problem: Medical Underwriting
Here’s the critical issue most people don’t know about when they try to switch from Medicare Advantage to Original Medicare: returning to Original Medicare is only half the equation.
Once you’re back on Original Medicare, you’ll want a Medicare Supplement (Medigap) Plan G to cover your out-of-pocket costs. But outside of your original 6-month Medigap open enrollment window, insurance companies can use medical underwriting — meaning they can deny you coverage or charge higher premiums based on your health history.
This is why I always tell clients: if you’re on Medicare Advantage and thinking about switching, do it sooner rather than later. The longer you wait, the more your health may change, and the harder it becomes to qualify for Medigap.
Special Enrollment Periods for Switching
In some situations you may qualify for a Special Enrollment Period (SEP) to switch from Medicare Advantage to Original Medicare outside the standard windows:
You moved out of your plan’s service area
Your plan is leaving the Medicare program
You qualify for Extra Help (Low Income Subsidy)
You were misled by your plan or agent
The Social Security Administration and Medicare handle these situations case by case. If you think you qualify, act quickly — SEP windows are typically 60 days.
Step-by-Step: How to Switch Back to Original Medicare
Confirm you’re in an eligible enrollment window (MA OEP, AEP, or SEP)
Contact your Medicare Advantage plan to disenroll — call the number on your plan card
Confirm your return to Original Medicare Parts A and B
Apply for a Medicare Supplement (Medigap) plan — do this simultaneously if possible
Sign up for a Part D prescription drug plan if you need one
Ready to Switch? I Can Help
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I don’t sell Medicare Advantage — and I help Arizona seniors navigate the process to switch from Medicare Advantage to Original Medicare and get enrolled in the right Medigap plan. My help costs you nothing extra.
If you’ve been searching for “Medicare Part G,” here’s the clarification: there is no Medicare Part G. What you’re looking for is Medicare Supplement Plan G — also called Medigap Plan G. It’s the most comprehensive Medicare supplement available to new enrollees in 2026, and most independent brokers consider it the gold standard for a reason. Here’s exactly what it covers and why it stands out.
What Is Medicare Supplement Plan G?
Medicare Supplement Plan G is a Medigap plan that fills in most of the gaps Original Medicare leaves behind. Think of Original Medicare (Parts A and B) as a solid foundation with some expensive holes — 20% coinsurance on doctor visits, a $1,736 hospital deductible, and no out-of-pocket maximum. Medicare Supplement Plan G patches nearly all of those holes.
It’s sold by private insurance companies but standardized by the federal government, so the benefits are identical regardless of which company you buy from. What differs is the monthly premium — and that’s where comparison shopping matters.
What Plan G Covers in 2026
Medicare Supplement Plan G covers the following in 2026:
Part A deductible — $1,736 per benefit period
Part A coinsurance and hospital costs — up to 365 days after Medicare benefits are used
Part A hospice care coinsurance
Skilled nursing facility coinsurance
Part B coinsurance or copayments — 100% covered after the Part B deductible
Part B excess charges — if a doctor charges more than Medicare allows, Plan G covers the difference
Foreign travel emergency care — up to plan limits
The only cost you pay with Medicare Supplement Plan G is the annual Part B deductible — $283 in 2026. After that, you owe nothing for covered services for the rest of the year. No copays, no coinsurance, no networks.
Why Plan G Is the 2026 Gold Standard
Plan G replaced Plan F as the top-tier Medigap option when Plan F was discontinued for new enrollees in 2020. The only difference between Plan F and Plan G is the Part B deductible — Plan F covered it, Plan G doesn’t. Since the deductible is only $283 per year, and Plan G premiums are typically $30–$50 less per month than Plan F, Plan G almost always wins on math.
According to Medicare.gov, Plan G is one of the most comprehensive Medigap plans available and one of the most widely purchased by new Medicare enrollees.
Plan G vs Plan N: Which Is Right for You?
The most common comparison is Medicare Supplement Plan G vs Plan N. Plan N has lower premiums but adds:
Up to $20 copay per office visit
Up to $50 copay per emergency room visit (waived if admitted)
No coverage for Part B excess charges
If you’re healthy and see doctors infrequently, Plan N may save you money. If you want maximum simplicity and predictability, Medicare Supplement Plan G is the better choice. I compare both for every client and let the numbers speak.
Mayo Clinic Coverage With Medigap
Mayo Clinic Arizona accepts Original Medicare — and therefore accepts Medicare Supplement Plan G. Most Medicare Advantage plans are not accepted at Mayo Clinic. If access to major specialty hospitals matters to you, Plan G is your path.
Get a Free Medigap Quote in Arizona
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I’ve been helping Arizona seniors enroll in the right Medigap plan since 2004. I compare rates from multiple carriers and find you the lowest premium for identical coverage.
Missing a Medicare enrollment deadline doesn’t just mean you sign up late — it can mean paying higher premiums for the rest of your life. Medicare late enrollment penalties are permanent, and most people don’t find out about them until it’s too late. Here are 8 penalties you need to know and exactly how to avoid each one.
1. Medicare Part A Late Enrollment Penalty
Most people get Part A free because they or a spouse paid Medicare taxes for at least 10 years. If you don’t qualify for free Part A, you can buy it — but if you miss your initial enrollment window, your premium goes up 10% for twice the number of years you went without coverage.
How to avoid it: Enroll during your Initial Enrollment Period — the 7-month window starting 3 months before your 65th birthday month.
2. Medicare Part B Late Enrollment Penalty
This is the most common and most costly Medicare late enrollment penalty. If you delay Part B without having qualifying “creditable coverage” from an employer, your premium goes up 10% for every full 12-month period you could have had Part B but didn’t — permanently.
In 2026, the standard Part B premium is $202.90/month. A two-year delay means an extra $40.58/month for life. A five-year delay means an extra $101.45/month — every month, forever.
How to avoid it: Enroll in Part B during your Initial Enrollment Period, or get a Special Enrollment Period through active employer coverage (not COBRA, not retiree coverage).
3. Medicare Part D Late Enrollment Penalty
If you go 63 or more consecutive days without creditable prescription drug coverage, you’ll pay a permanent penalty added to your Part D premium. The penalty is 1% of the national base beneficiary premium per month you went without coverage.
How to avoid it: Enroll in Part D when you first become eligible, or maintain creditable drug coverage from an employer plan.
4. Medigap Open Enrollment Penalty
This isn’t a formal penalty — it’s worse. When you first enroll in Medicare Part B, you have a 6-month window to buy any Medicare Supplement (Medigap) plan without medical underwriting. After that window closes, insurers can deny you or charge more based on your health history.
How to avoid it: Apply for your Medigap plan during your open enrollment window — the 6 months starting when you’re 65 and enrolled in Part B.
5. Medicare Advantage Switching Penalty
This is the one-way door problem. If you enroll in Medicare Advantage and later want to switch to a Medigap supplement plan, you may need to pass medical underwriting. The longer you stay on Advantage, the more health conditions you may accumulate — and the harder it becomes to qualify for Medigap.
How to avoid it: Think carefully before choosing Medicare Advantage. Once you’re in for more than a year, the exit may be medically complicated.
6. IRMAA Income Surcharge Surprise
Higher-income Medicare enrollees pay more for Part B and Part D through the Income-Related Monthly Adjustment Amount (IRMAA). The surcharge is based on your income from two years prior — so a high-income year in 2024 affects your 2026 premiums.
How to avoid it: If your income dropped significantly, file a Life-Changing Event appeal with Social Security. You can request they use more recent income data.
7. Missing the AEP Deadline
The Annual Enrollment Period (AEP) runs October 15 – December 7. If you miss it and want to make changes to a Medicare Advantage or Part D plan, you may have to wait until the next AEP or qualify for a Special Enrollment Period.
How to avoid it: Mark your calendar every year. Review your plan’s Annual Notice of Change (ANOC), which arrives in September.
8. Not Checking Your Employer Coverage Status
Many people delay Medicare enrollment because they’re still working and have employer coverage. This is fine — but only if that employer coverage is “creditable.” Coverage from a company with fewer than 20 employees may not qualify, and delaying Part B in that situation triggers the late enrollment penalty.
How to avoid it: Confirm with your HR department or benefits administrator whether your employer coverage is creditable before delaying Medicare enrollment.
Get Help Avoiding Medicare Late Enrollment Penalties in Arizona
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I help Arizona residents navigate Medicare late enrollment penalties, enrollment windows, and supplement plan choices — at no cost to you.
The health insurance rate cliff refers to the sudden, dramatic premium increase that occurs when ACA subsidies expire or when someone’s income exceeds the subsidy threshold. In 2026, millions of Arizona residents face this cliff — and time is running out to find alternatives before open enrollment closes. Here’s what you need to know.
It’s January 19, 2026, and if you haven’t secured your health insurance for the year yet, the clock isn’t just ticking—it’s practically screaming. While Open Enrollment for the Health Insurance Marketplace officially closed for most of the country on January 15, a few states (like California, New York, and New Jersey) have extended deadlines through the end of the month.
Whether you missed the deadline or were simply paralyzed by the “sticker shock” of this year’s prices, you aren’t alone. 2026 has brought some of the most significant changes to the health insurance landscape in nearly a decade.
The Perfect Storm: Rate Hikes and Subsidy Cuts
If you logged into the Marketplace this year and saw a premium that looked like a mortgage payment, there’s a reason for it. We are currently facing what experts are calling the “2026 Rate Cliff.”
The Expiration of Enhanced Subsidies: The extra financial help provided by the Inflation Reduction Act expired on December 31, 2025. For many families, this “cancellation” of extra credits means out-of-pocket costs have jumped by 75% or more for the exact same coverage.
Double-Digit Rate Increases: On top of the lost subsidies, insurers have raised base premiums by a median of 18–20% this year, citing rising labor costs in hospitals and the high price of new weight-loss and specialty medications.
For many, the “Affordable” Care Act simply doesn’t feel affordable anymore.
A Flexible Alternative: Short-Term Medical (STM)
If the Marketplace has priced you out, or if you missed the window to enroll, Short-Term Medical plans have become a go-to alternative for 2026.
Unlike the restrictive rules of previous years, many states now allow for extended STM plans that provide up to 3 years of coverage (through renewable 364-day terms).
Why consider Short-Term Medical?
Affordability: Monthly premiums are often 50–80% lower than unsubsidized Marketplace plans.
Speed: Coverage can often start as soon as tomorrow.
Flexibility: You can drop the coverage at any time if a better option (like a new job) comes along.
Note: These plans are best for healthy individuals. Because they are not ACA-compliant, they typically use medical underwriting and may not cover pre-existing conditions or maternity care.
Bridging the Gap with Supplemental Coverage
Because many of the “affordable” plans for 2026—including Bronze and Catastrophic plans—come with very high deductibles, Supplemental Coverage is more important than ever. These plans pay cash directly to you to cover your deductible if the worst happens:
Accident Expense: Covers out-of-pocket costs from ER visits or broken bones.
Critical Illness: Provides a lump sum if you are diagnosed with a major illness like cancer or a heart attack.
Hospital Indemnity: Pays you a set amount for every day you are confined to a hospital bed.
Don’t Go It Alone: Talk to a Local Broker
Navigating the 2026 market is like walking through a minefield. This is not the year to “DIY” your health insurance. A local independent broker is your best resource—and the best part? Their services are usually free to you.
A local broker knows which hospital networks are actually participating in which plans and can help you weigh the risk of a Short-Term plan versus an ACA plan.
How to find a pro:
When you search for a broker in your area, look closely at their Google Reviews. * Are they responsive?
Do they help when a claim gets denied?
Do they actually listen, or are they just “selling”?
A high rating from your neighbors is the best insurance that you’re getting honest advice.
Facing a health insurance rate cliff? I compare all Arizona options — ACA marketplace, off-exchange PPOs, and short-term plans — at no cost. Call Andy Orlikoff at (623) 742-3878 or fill out the contact form.
Most people don’t realize that missing the Medicare enrollment deadline doesn’t just mean signing up late — it means paying higher premiums for the rest of your life. The 7-month Initial Enrollment Period is the most important window in your entire Medicare journey. Here’s exactly what it is, when it opens, and what happens if you miss it.
What Is the 7-Month Medicare Enrollment Deadline?
The Initial Enrollment Period (IEP) is a 7-month window that surrounds your 65th birthday. This is your primary opportunity to enroll in Medicare without facing permanent late enrollment penalties. The window runs:
3 months before your birthday month
Your birthday month itself
3 months after your birthday month
Missing this Medicare enrollment deadline — without having qualifying employer coverage — triggers late enrollment penalties that are permanent and compound over time.
The Medicare Part B Late Enrollment Penalty
The Part B penalty is the most damaging. For every full 12-month period you could have had Part B but didn’t, your premium goes up 10% — permanently. According to Medicare.gov, the standard Part B premium in 2026 is $202.90/month. Here’s what a delay costs:
1-year delay: +$20.29/month forever
2-year delay: +$40.58/month forever
5-year delay: +$101.45/month forever
Over a 20-year retirement, a 2-year delay costs over $9,700 in extra premiums — from a single avoidable mistake.
When Can You Delay Without Penalty?
You can delay enrolling beyond the IEP without penalty only if you have active coverage through a current employer (yours or a spouse’s) at a company with 20 or more employees. Importantly:
COBRA does not count as qualifying coverage for this exception
Retiree health coverage does not count
The employer must currently employ you — not just be offering retiree benefits
When that employer coverage ends, you get a Special Enrollment Period of 8 months to sign up for Medicare without penalty.
The Part D Late Enrollment Penalty
Part B is not the only late penalty. If you go 63 or more days in a row without Part D or other creditable drug coverage after you are first eligible, you pay an extra 1% of the national base beneficiary premium for each month you went without it, which is 12% for a full year. According to Medicare.gov, that base premium is $38.99 in 2026, so each uncovered month adds about 39 cents to your monthly Part D premium. A full year without coverage adds about $4.68 a month.
A Simple Example of the 7-Month Window
If your 65th birthday is in July, your Initial Enrollment Period runs from April through October.
The Medigap Open Enrollment Window
Tied to the Medicare enrollment deadline is an equally important window for Medigap: the 6-month open enrollment period that starts when you’re 65 and enrolled in Part B. During this window, no insurer can deny you a Medicare Supplement Plan G or charge more based on your health. After it closes, underwriting applies.
This window only happens once. Once it’s gone, switching to Medigap may be medically difficult or impossible.
Get Help With Medicare Enrollment in Arizona
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I help Arizona seniors navigate the Medicare enrollment deadline — making sure they enroll at the right time and choose the right coverage without paying permanent penalties.
