"Once you're on Medicare Advantage, you can't go back."
You may have heard that from a friend, a neighbor, or even a salesperson. It's false.
Every year during Open Enrollment, October 15 to December 7, anyone can leave a Medicare Advantage plan and return to traditional Medicare. No health questions. No approval needed.
The real catch is the Medigap plan most people want alongside traditional Medicare. Whether you can get one without health questions comes down to one question:
Is your plan leaving you, or are you leaving it?
This guide shows you how to switch from Medicare Advantage to traditional Medicare, step by step.
Which Medicare Advantage plans are leaving Southern Oregon in 2027?
- Most plans are leaving Jackson County in 2027, with a drop from 27 Medicare Advantage plans to 11, and Josephine County drops from 26 to 10, per CMS published plan data.
- Regence and Wellcare are leaving both counties completely, and Aetna's and UnitedHealthcare's standard plans are ending. Per KOBI-TV Regence alone affects about 12,000 local residents.
For most people, only two insurers remain in both counties:
- Aetna Medicare (HMO): Elite (with drug coverage) and Eagle (no drug coverage) - note that HMO plans generally do not have out of network coverage
- ATRIO Health Plans (PPO): Choice Rx and Prime Rx (with drug coverage) and Freedom (no drug coverage) - note that many providers in Jackson county, PT2U included, will not take Atrio even out of network due to challenges being paid.
The other remaining plans are Special Needs Plans, open only to people who have Medicaid, certain chronic conditions, or live in a care facility. Confirm what's available at your address on Medicare Plan Finder.
If you received a letter saying your plan is ending you likely have a guaranteed right to Medigap. See Scenario 1 below, and don't wait. The window is limited.
What's the difference between Medicare and Medicare Advantage?
- Traditional Medicare (Parts A and B) lets you see any provider who accepts Medicare, usually without prior authorization. Most people add Medigap for their share of costs and Part D for drugs.
- Medicare Advantage (Part C) is a private plan that replaces your A and B coverage, usually with a network, prior authorizations, and extras like dental.
- Medigap is not a "Part." Medigap plans use letters too, but Medigap Plan A is not Medicare Part A. These are supplemental plans to Traditional Medicare.
New to the differences? Read our full comparison first: Medicare vs. Medicare Advantage Insurance.
What is Medigap?
- Standardized. Example: every Plan G has the same benefits, whichever company sells it. Only the price differs.
- Not the same as "secondary insurance." Retiree plans and Medicaid also pay after Medicare, but their benefits vary. Medigap's don't.
- Pays your share, adds nothing new. If Medicare doesn't cover it, Medigap won't either.
- No drugs, dental, or vision. Add a Part D plan for prescriptions.
- Part B deductible: only Plans C and F cover it, and they're closed to anyone first eligible for Medicare on or after January 1, 2020.
Can you switch from Medicare Advantage back to traditional Medicare? Switching back: the one question that matters.
Getting back to traditional Medicare is easy. Getting Medigap is the hard part.
Outside a few protected situations, Medigap insurers in Oregon can ask health questions, then deny you or charge more. This is called medical underwriting. So ask yourself:
Is your plan leaving you, or are you leaving it?
If your plan is ending:
- You can go back to traditional Medicare.
- Medigap is guaranteed. No health questions, and you can't be denied or charged more.
- Apply for Medigap up to 60 days before your plan ends, and no later than 63 days after.
If you leave by choice:
- You can go back to traditional Medicare during an allowed window.
- Medigap is usually not guaranteed. Expect health questions, and you can be denied or charged more.
- Apply for Medigap before you leave your Advantage plan.
What happens if your Medicare Advantage plan is ending?
If your Advantage plan is ending, you can absolutely return to traditional Medicare with a Medigap plan. Federal law gives you a guaranteed issue right (Medicare.gov):
- No health questions
- No denial or higher price because of your health
- No waiting period for pre-existing conditions
You qualify if your plan:
- Is leaving Medicare or not renewing
- Stops serving your county
- No longer covers you because you moved
Watch out: this right only applies if you go to traditional Medicare. Choose another Advantage plan instead and you'll likely lose it. For many people, this is a rare chance at Medigap with no questions asked.
Key dates (plan ending December 31, 2026)
- Non-renewal letter mailed: by October 2, 2026
- Open Enrollment: October 15 to December 7, 2026
- Current plan still works: through December 31, 2026
- Special Enrollment Period: December 8, 2026 to February 28, 2027
- Medigap guaranteed window: 60 days before your plan ends, up to 63 days after (early March 2027)
Sources: Medicare Rights Center, Medicare.gov. Confirm your exact deadline with SHIBA.
If you do nothing
- You're moved to traditional Medicare on January 1. You keep Medicare.
- You'll have no Medigap and no drug coverage until you sign up.
- Traditional Medicare alone has no yearly cap on your 20% share.
Which Medigap plans are guaranteed
- Plans A, B, D, G, K, and L from any company selling in Oregon
- Plans C and F, only if you were eligible before January 2020
- Plan N isn't on the federal list. Ask SHIBA or the insurer. These plans often have a lower premium but also have small co-pays for services.
Don't forget Part D
Medigap doesn't cover drugs. Pick a Part D plan by December 31 so it starts January 1. Going 63 days or more without drug coverage can mean a lifelong late penalty.
Quick tips
- Keep your non-renewal letter as proof.
- Tell the Medigap company you're using a guaranteed issue right.
- Apply in October or November for a January 1 start.
- Shop around. Same Plan letter (such as G) can have different prices depending on the insurer.
- Confirm your providers accept traditional Medicare. If they do, your Medigap plan works with them automatically, with no network to check.
What if you leave Medicare Advantage by choice?
You can leave an Advantage plan that's still available. But unless an exception applies (next section), Medigap insurers can review your health and say no.
When you can switch
- Open Enrollment (October 15 to December 7): return to traditional Medicare and add Part D. Changes start January 1.
- Medicare Advantage Open Enrollment (January 1 to March 31): one change, either to another Advantage plan or back to traditional Medicare plus Part D.
- Special Enrollment Periods (varies): triggered by events like moving or losing other coverage.
These windows let you leave. They don't make a Medigap insurer accept you.
8 pitfalls to avoid
- Getting declined. Heart disease, cancer, or recent or upcoming surgery can mean a denial or a higher rate.
- Dropping Advantage before Medigap is approved. The costliest mistake. If you're declined, you're left with traditional Medicare alone: 20% of your costs, no cap, until your next window.
- Counting on Oregon's birthday rule. It only lets people already on Medigap switch plans. It won't get you in from Advantage.
- Sticker shock. Medigap plus Part D usually costs more per month. The tradeoff is predictable costs when you get care.
- Losing extras. Dental, vision, hearing, and fitness benefits go away. You can buy separate plans.
- A drug coverage gap. Sign up for Part D at the same time. A gap of 63+ days can mean a permanent penalty.
- Wasting your one change. The January to March window allows only one switch.
- Incomplete health answers. An undisclosed condition can get your policy cancelled later.
The safe order
- Apply for Medigap while still on your Advantage plan.
- Get written approval.
- Then switch during an allowed window, and add Part D.
- Line up all start dates with the day your Advantage plan ends.
When is Medigap guaranteed even if you leave by choice?
These situations guarantee Medigap even when you choose to leave (OAR 836-052-0142):
- Trial right 1: You joined Advantage when you first got Medicare at 65, and leave within 12 months. You can buy any Medigap plan sold in Oregon (some letters depend on when you became eligible).
- Trial right 2: You dropped Medigap to try Advantage for the first time, and leave within 12 months. You can get your old Medigap plan back if it's still sold, or certain others.
- Plan broke the rules: It misled you or didn't follow its contract. You can buy certain Medigap plans.
- You moved out of the plan's service area. See the section: "What happens if your Medicare Advantage plan is ending?"
Apply up to 60 days before and no later than 63 days after your Advantage coverage ends. Trial rights are one-time, first-time only. Keep your paperwork and tell the insurer which right you're using.
Your switching checklist
- Read your plan letter. Is your plan ending?
- Save any non-renewal letter.
- Ask your doctors, therapist, and hospital what insurance they'll accept next year.
- List your prescriptions and compare Part D plans on Medicare.gov.
- Pick a Medigap plan letter (G, N, and high-deductible G are common).
- Get quotes from more than one company.
- Apply for Medigap. If leaving by choice, wait for written approval.
- Enroll in Part D to start the same day.
- Carry your Medicare, Medigap, and Part D cards on day one.
Quick answers
Will I lose Medicare if my Advantage plan ends? No. You're moved to traditional Medicare automatically on January 1.
Can I really leave Advantage during Open Enrollment? Yes. Anyone can return to traditional Medicare from October 15 to December 7, no questions asked. Only Medigap may involve health questions.
Can I have Advantage and Medigap together? No. Medigap only works with traditional Medicare.
Does Medigap help with physical therapy at home? Yes, when it's medically necessary outpatient therapy from a Medicare-enrolled therapist. Medigap pays its share of what Medicare covers.
Where can I get free, unbiased help? Oregon SHIBA: 1-800-722-4134. Certified volunteers who don't sell insurance.
Before you decide, ask yourself
- Do I want any provider who takes Medicare, or am I fine with a network?
- Would I rather pay more monthly for predictable costs, or less monthly with copays and authorizations?
- How much do dental and vision extras matter?
- Will my doctors and therapist accept my plan next year?
- Is my plan ending, giving me a guaranteed shot at Medigap I may not get again?
Then talk with SHIBA or a licensed, independent Medicare agent who can compare plans using your medications and providers.
A word of caution if you're considering ATRIO
ATRIO Health Plans is one of the few Medicare Advantage options still offered in our area. If you're considering it, PT2U strongly recommends checking with every one of your providers first to confirm they accept ATRIO.
- There is a sizable lawsuit. Asante has sued ATRIO over unpaid claims, and ATRIO disputes it. ATRIO has also been out of network with Asante since January 1, 2026. Read the KOBI-TV news report linked at the bottom of this post.
- Our own experience. PT2U is not contracted with ATRIO. When we have billed ATRIO for basic physical therapy, we have seen payment delays of more than six months. Despite repeated attempts, we have been unable to reach a person at ATRIO to resolve these claims. At the end of the day the clinic has to be able to keep the doors open.
- We're not alone. Through our billing specialists and direct conversations with other local clinics, we know a number of providers, PT2U included, will no longer work with ATRIO because claims are not paid within the prompt-payment timeframes our other insurers routinely meet.
Why it matters to you: when a plan doesn't pay your doctors and clinics, you can face delays, denied claims, or bills down the road, especially with out-of-network providers. Ask before you enroll, not after.
Sources
Questions about your therapy coverage?
PT2U brings outpatient physical therapy to your home in Medford, Ashland, Central Point, Phoenix, Talent, Eagle Point, and Jacksonville, and accepts traditional Medicare. Changing coverage for 2027? Contact PT2U and we'll help you understand how it affects your care.
Medicare rules, deadlines, and plan availability can change. Confirm details with Medicare (1-800-MEDICARE), Oregon SHIBA, or a licensed agent before making coverage decisions.
This content is for general educational purposes only and is not medical advice. It does not create a patient relationship with PT2U or Dr. Jeremy Brady. Talk with your physician or physical therapist before starting a new exercise program, and seek emergency care for urgent symptoms.
