ArcaMax

Hello, Toni:

I moved to Houston from Little Rock in May and discovered your Medicare article in the local newspaper. I enrolled in Medicare Advantage HMO when I turned 65 in March. I didn’t realize I could have chosen a Medicare Supplement to my Parts A and B instead of a Medicare Advantage plan. The article explained that I have a 6-month Medicare Supplement window to change from this HMO.

I have been diagnosed with lung cancer, and the cancer center that my physician uses is not in the HMO’s network. I need help disenrolling from this HMO and going back to Traditional Medicare with a Medicare Supplement since I am in the 6-month Part B window because Part B started March 1.

Time is ticking and I need to do this fast!! Toni, you have no idea what a blessing it was to discover your article. Thanks so much.

—James, a new Texas resident

Hi there, James, and welcome to Texas:

I know how overwhelming it can be to understand Medicare’s rules, especially when you are mentally stressed due to an illness. Below is how I help clients who want to disenroll from their Medicare Advantage plan and return to “Traditional” Medicare, also known as “Original” Medicare.

There is a Special Enrollment Period (SEP) to help you qualify for a change from your Medicare Advantage plan. The SEP is a time period triggered by specific circumstances. During this specific time period, a Medicare recipient is allowed to join, switch or drop a Medicare Advantage or Medicare Part D Prescription Drug Plan. Page 80 of the 2026 Medicare & You handbook explains in detail how a Medicare beneficiary can change a Medicare Advantage or Medicare Part D drug plan. Below are a few of the circumstances that can trigger a Medicare change:

—Moving out of area, such as when James moved from Arkansas to Houston

—Newly enrolled in Medicaid

—Qualified for Extra Help for prescription drugs

—Moving into a long-term care facility such as skilled nursing, assisted living, personal care homes and Alzheimer’s living facilities

—Loss of creditable prescription drug coverage (employer benefits from you or your spouse’s employment)

The trick to disenrolling from a Medicare Advantage Plan when a SEP is granted is to enroll in a stand-alone Part D plan, which will automatically disenroll you from your Advantage plan and back to Original/Traditional Medicare. James, because you want to be enrolled in Original Medicare as soon as possible, I would suggest that you go to www.medicare.gov and enroll in whichever Medicare Part D plan best fits your prescription drug needs. The change to Medicare will be effective on the first of next month.

Because you enrolled in Part B this March, you are correct that you’re within your 6-month Medicare Open Enrollment Period (OEP), which will end on Aug. 31. Wait past 6 months of enrolling in Part B, then the Medicare beneficiary must qualify by medical underwriting. James, you received a “little blessing” when you read my article and learned you have other Medicare options to use!

James, since your Medicare Parts A and B began March 1, then you can only apply for Medicare Supplement Plans G or N. (Those with Part A that began prior to Jan. 1, 2020, can apply for Medicare Plan F.) The difference between Medicare Supplement Plan G and Plan N is:

—Plan G offers lower premiums than Plan F, with the 2026 Part B deductible of $283 not covered.

—Plan N has a lower premium than Plan G with higher out-of-pocket costs. There is a $20 co-pay for a doctor’s visit and a $50 co-pay for the emergency room. Part B deductible and “excess charges” are not paid for by the insurance company.

Remember, with Medicare, what you don’t know WILL hurt you!

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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.

©2026 Toni King. Distributed by Tribune Content Agency, LLC.

Copyright 2026 Toni King, Distributed by Counterpoint Media