Are My Doctors Still in My Medicare Plan's Network Next Year?

If you have a Medicare Advantage plan, your plan should have mailed you an Annual Notice of Change by September 30. It lists what changes on January 1, and that can include which doctors, hospitals and pharmacies are in your network. Medicare Open Enrollment runs October 15 to December 7, so you have time to check before you decide whether to keep your plan.

Here's how to check, one step at a time.

01Why can my doctors change from year to year?

Medicare Advantage and Part D drug plans are run by private companies approved by Medicare. According to the National Council on Aging, these plans can change their provider networks and other plan terms every year.

A doctor's office can also leave a network on its own. A doctor who was in your network this year isn't guaranteed to be in it next year.

02Does this apply if I have Original Medicare?

The network part doesn't. Original Medicare has no network. You can see any doctor in the country who accepts Medicare, with or without a Medicare Supplement.

Your Part D drug plan is different. It can change its drug list and its pharmacy network, so the prescription steps below apply to you too.

03How do I check my doctors, specialists and hospital?

1. Make a list. Every doctor, every specialist, the hospital you'd want to go to, and any lab or therapy office you use.
2. Find the network section of your Annual Notice of Change.
3. Look each one up in your plan's provider directory for 2027, not 2026. It's on the plan's website, or call the member services number on your card.
4. Call each office and ask for billing. Ask whether they'll be in your plan's network in 2027, and give the plan's full name.

The front desk may tell you "we take Medicare." That's a different question. Ask about your plan, by name, for next year.

If the directory and the office don't agree, call the plan and ask them to confirm.

04How do I check my prescriptions and pharmacy?

1. Write down every prescription with the dose.
2. Check each one against your plan's 2027 drug list. It's in your Annual Notice of Change or on the plan's website.
3. Check that your pharmacy is still in the network.

You can also enter your prescriptions and pharmacy at Medicare.gov to see which plans in your area cover them.

Your Annual Notice of Change also lists any changes to what you'll pay next year. Read that section too.

Not sure how this applies to your own situation? I'll walk through it with you. No cost for the help, and no obligation to enroll.

Logan Cope · Licensed Insurance Agent

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05What if something changed?

You don't have to stay with your plan. From October 15 to December 7, you can switch Medicare Advantage plans, go back to Original Medicare, or change drug plans. Your new coverage starts January 1. My post on when Medicare Open Enrollment is and what you can change walks through each option.

If everything checks out, you don't have to do anything. Your plan renews on its own.

You can make these calls yourself, or have a licensed Medicare agent in Rogersville, TN, like me, make them with you.