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.
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.
Medicare is changing significantly in 2026, and Arizona seniors need to understand what’s new. From prescription drug cost caps to shifts in Medicare Advantage, the state of Medicare 2026 looks different from previous years. Here’s your complete guide to what changed and how to avoid surprise bills.
Part D Drug Cost Cap Rises to $2,100 in 2026
The annual out-of-pocket cap on Part D prescription drug costs, which began at $2,000 in 2025 under the Inflation Reduction Act, is $2,100 in 2026.
What it means for you: once you’ve paid $2,100 in out-of-pocket drug costs in a calendar year, your Part D plan covers 100% of covered drug costs for the rest of the year. Previously, there was no true cap — catastrophic coverage kicked in at a much higher threshold.
Medicare Advantage Changes in 2026
The state of Medicare 2026 includes significant Medicare Advantage turbulence. Several major insurers reduced benefits, raised copays, or exited markets entirely. According to CMS, payment pressures on Medicare Advantage plans have forced carriers to make tough tradeoffs.
Key changes affecting Arizona Medicare Advantage enrollees in 2026:
UnitedHealthcare significantly reduced its Medicare Advantage footprint nationwide
Many plans cut extra benefits like dental allowances and OTC credits
Prior authorization requirements continue to expand
Out-of-pocket maximums for many plans increased
How to Avoid Surprise Bills in 2026
Surprise bills remain a major concern for Medicare beneficiaries. Here’s how to protect yourself:
Verify your doctors are still in-network — Medicare Advantage networks change every January 1
Review your Annual Notice of Change (ANOC) — sent in September, it shows every change to your plan
Check your drug formulary — your medications may have moved to a higher tier
Consider Original Medicare with Plan G — no networks, no annual surprises, predictable costs
Medicare Supplement Plan G in 2026
For many Arizona seniors, the simplest way to avoid surprise bills is Medicare Supplement Plan G. After the Part B deductible ($283 in 2026), Plan G covers 100% of Medicare-approved costs. No networks. No prior authorization. No annual benefit changes to review.
Get Help Navigating Medicare in 2026
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I help Arizona seniors understand the state of Medicare 2026 and choose coverage that won’t surprise them when they need care.
Every fall, millions of seniors face the same decision: Medigap vs Medicare Advantage — which is right for me? Despite Medicare Advantage’s heavy marketing, a significant number of seniors deliberately choose Medigap over Medicare Advantage. Here’s why.
The Core Reason Seniors Choose Medigap Over Medicare Advantage
The fundamental difference: Medicare Advantage is cheaper at enrollment but can cost far more when you’re sick. Medigap vs Medicare Advantage comes down to predictability. With Medigap Plan G, after the Part B deductible ($283 in 2026), you pay nothing for covered services all year. With Medicare Advantage, copays, coinsurance, and prior authorizations can add up to thousands.
Nurses, doctors, and hospital administrators — people who see how insurance affects patients — consistently prefer Medigap for themselves and their families. The reason: when a serious illness hits, Medicare Advantage plans frequently require prior authorization, restrict networks, and deny claims that Original Medicare would cover.
According to Medicare.gov, Medigap plans work alongside Original Medicare and cover most of the gaps Original Medicare leaves — without network restrictions or prior authorization requirements.
Five Reasons Seniors Choose Medigap Over Medicare Advantage
Any doctor, anywhere: Medigap works with any provider who accepts Medicare — no networks, no referrals
No prior authorization: Your doctor decides your care — not an insurance company algorithm
Mayo Clinic access: Mayo Clinic Arizona accepts Original Medicare and Medigap — not most Advantage plans
Predictable costs: One deductible per year, then nothing for covered services
Stable benefits: Medigap benefits don’t change annually — no ANOC to review every September
When Medicare Advantage Might Still Make Sense
If you can’t afford Medigap premiums or qualify for low-income assistance programs, Medicare Advantage may be your best available option. However, the one-way door risk remains: if you later want to choose Medigap over Medicare Advantage, you may need to pass medical underwriting.
Get a Free Comparison in Arizona
I’m Andy Orlikoff, an independent Medicare broker in Surprise, AZ. I help Arizona seniors understand the real Medigap vs Medicare Advantage tradeoffs — and I don’t sell Advantage plans.
