Can I keep seeing my current doctors if I switch to a Medicare Advantage plan, or do I have to find new ones?

Question

Mary Turner · Accepted Answer

You may or may not keep your current doctor's when switching to a Medicare advantage plan. Some HMO's and PPO's have extensive networks and your doctors may all participate. If you decide on an HMO you just stay in network. PPO's allow you to go out of network though your cost may be higher.

Answered by Mary Turner on March 28, 2025

Broker Licensed in FL

Answered by Mary Turner Medicare Insurance Agent

Tony Capraro III · Answer

You'll have to use the DR's that are part of the Medicare Advantage Plan-you can easily check with Dr's and Hospitals to see if they're part of the Medicare Advantage plan you are looking to switch to. Have you looked into Medicare Supplement/Medigap-you'd be able to see any Dr that accepts Medicare!

Answered by Tony Capraro III on April 3, 2025

Agent Licensed in NH & ME

Answered by Tony Capraro III Medicare Insurance Agent

Melonie Wood · Answer

Whether you can keep your current doctors with a Medicare Advantage plan depends on whether they participate in the plan's network and if you choose a plan that allows you to see out-of-network doctors (PPO).

Answered by Melonie Wood on April 4, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent

Gary Church · Answer

Not necessary! Check with your doctor and the Medical Group to ensure the Medicare Advantage plan is in-network.

Robert Moore · Answer

As long as the doctors accept that medicare advantage carrier. Like group health insurance, there are several different types of coverage (HMO, PPO, PFFS...). So reviewing the provider network before selecting a carrier will be very important.

Answered by Robert Moore on May 19, 2025

Broker Licensed in IN, AL, IL & 11 other states

Answered by Robert Moore Medicare Insurance Agent

Marsha Reiniers · Answer

Medicare Advantage plans are managed care plans and have many physicians who are in network, so you will have a wide range of doctors and specialists to choose from. If you prefer to stay with your current doctor, make sure he or she is in network for the plan you select. Note: A PPO plan will allow you to see a doctor outside of the plan's network, usually at a higher co pay, however, that doctor must first agree to accept your PPO plan. It is very important to do your research and to enlist an agent who will help ensure your plan meets your specific needs.

Answered by Marsha Reiniers on April 21, 2025

Agent Licensed in FL, GA, NC, PA, SC & VA

Answered by Marsha Reiniers Medicare Insurance Agent

Justin Sonon · Answer

If your doctors are considered in network on an HMO style Medicare Advantage plan, you may keep them. If you choose a PPO style Medicare Advantage plan, you may go in and out of network, but should realize that if you go out of network, the cost to see that doctor will be higher than staying in network.

Answered by Justin Sonon on April 22, 2025

Broker Licensed in Pa, DE, FL & IL, MD, NJ & SC

Answered by Justin Sonon Medicare Insurance Agent

Randall Taylor · Answer

It's possible you might need to change doctors. Not every doctor accepts every plan. This means, if they don't accept the plan then the doctor(s) is/are NOT IN NETWORK. With a PPO, you can go out-of network, but you will pay higher out-of-pocket costs (copays, deductibles). With an HMO, generally, the out-of-network option doesn't even exist. This means, in most cases, you would pay 100% for the medical service/appointment and your plan would pay nothing. And lastly, Medicare Advantage plans change every year. One of the consequences of this is that your current plan may not be accepted by your current doctor(s) for the following calendar year.

Answered by Randall Taylor on April 30, 2025

Broker Licensed in TX, MI & WI

Answered by Randall Taylor Medicare Insurance Agent

Alison Hummel · Answer

Yes, but you have to make sure that all your doctors are within the network. If you have a PPO, you likely have out-of-network access to doctors and hospitals at a higher cost.

Robert Fracchia · Answer

More than likely, you can keep your current doctors. It is always best for your agent to double-check to see that all of your doctors are in network.

Steven Bleicher · Answer

Should any of your current doctors be registered in the Advantage plan of your choice (during the next Annual Open Enrollment period in the fall for a 1/1/26 effective date), they are yours to retain. Though I have found that, for example, if a client has 5 doctors that they want to keep, 2 will be in one network and the rest will be in another one. At that point, you must decide which of those doctors are more important to you, whether it is the 3-doc network or the 2-doc network.

Answered by Steven Bleicher on May 2, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Norman Smith · Answer

Ahhhh… but that is the true concern isn’t it! So here’s the proper answer:

Maybe!!!

Your Doctor may today accept your Medicare Advantage plan. You’d have to check with the office to see which they will accept and which they won’t, IF THEY ACCEPT THEM AT ALL!!! 
The other concern is EVEN IF he/she accepts them today, with the consistent changes in the Medicare program allowances, your office may elect to NOT accept any MA plans in the future.
So if having your Doctor is a major concern, if choosing any doctor and having the complete control of your health care moving forward is important to you, and that wherever you are in the USA that you have the CHOICE OF YOUR MEDICAL PROFESSIONAL, and to have coverage at the BEST FACILITIES IN THE COUNTRY BECAUSE YOU CAN, then keep your Original Medicare and get the best Supplement plan you can. 

During Open Enrollment it is the ONLY TIME you will choose your Medical coverage with NO UNDERWRITING!!! So I encourage you to get it right now!

Dana Dane · Answer

If you work with an agent they can look up your health care providers to check in-network providers. If you are taking medications, please check to make sure they are covered and how much they would cost you.

Answered by Dana Dane on May 12, 2025

Agent Licensed in OR, AZ, CA & 6 other states

Answered by Dana Dane Medicare Insurance Agent

Chad Watkins · Answer

With Medicare Advantage plans, you will want to check if your doctor is in network as that will provide you with the lowest copay. You can always use an out-of-network doctor, but your copay may be higher possibly even costing you 100% out-of-pocket.

Answered by Chad Watkins on May 16, 2025

Agent Licensed in NJ, AK, AL & 48 other states

Answered by Chad Watkins Medicare Insurance Agent

Bill Wheeler · Answer

Yes , you may keep your doctor, but it depends on the plan (such ad a HMO) and if they are in network. A PPO plan will allow you to see your doctor and other's who except medicare and the plans terms.

Answered by Bill Wheeler on May 27, 2025

Broker Licensed in KY & IN

Answered by Bill Wheeler Medicare Insurance Agent

Ami Fouts · Answer

Yes, Most Medicare Advantage plans accept most doctors. But it is always prudent to check all doctors in network

James Stang · Answer

That depends on your plan and your provider. If you enroll in a HMO, your provider would need to be in network in most cases. A PPO plan would allow you to see non-network providers if they are willing to bill the carrier and there is sometimes a higher cost.

Answered by James Stang on June 1, 2025

Agent Licensed in OH

Answered by James Stang Medicare Insurance Agent

Aaron Lewis · Answer

You can keep seeing your doctor if they are in the Medicare Advantage Plan network. If your doctor is out of network and you have a HMO program you will be responsible for paying all costs. A PPO program has some flexibility where you might be able to go out of network but you will most likely pay a higher copayment for seeing an out of network provider .

Answered by Aaron Lewis on May 12, 2025

Agent Licensed in NJ & NY

Answered by Aaron Lewis Medicare Insurance Agent

Fred Manas · Answer

Whether you can keep your current doctors depends on whether they are in the network of your new Medicare Advantage plan. With Original Medicare, you can see any doctor who accepts Medicare. However, with Medicare Advantage plans, you're typically limited to doctors within the plan's network. 
Elaboration:
Original Medicare:
If you have Original Medicare (Parts A and B), you can see any doctor who accepts Medicare. 
Medicare Advantage Plans:
With Medicare Advantage plans (Part C), you're generally restricted to doctors who are in the plan's network. 
Checking Your Doctor's Network:
Before switching to a Medicare Advantage plan, it's crucial to confirm if your current doctors are in the network of the plan you're considering. You can do this by checking the plan's website or contacting the plan's member services. 
Switching if Necessary:
If your doctor is not in the network, you may need to find a new doctor within the plan's network. You can use the plan's online directory or contact member services for assistance in finding a new doctor.

Carol Thompson · Answer

That depends on whether your current pcp participates and or is contracted to accept Medicare advantage plans. As an agent I always check to see if a pcp is in the networks of Medicare advantage plans.

Answered by Carol Thompson on May 26, 2025

Broker Licensed in FL, LA, MI & NC, SC, VA & WI

Answered by Carol Thompson Medicare Insurance Agent

Suzanne Lamperti · Answer

That depends if your current physician is part of the Medicare Advantage network. It's better to stay with Irigional Medicare and have a Meducare Supplement.

Mel Stevens · Answer

When it comes to Medicare Advantage plans, there are many different providers and usually many different plans available per provider. If you are thinking about switching plans, it's important to review the plan and make sure your doctors, specialists and medical facilities that are a must keep are available within that plans network. When researching, be very cognizant of the particular plan. For example, Doctor X may be in network with United Medicare Advantage HMO plan 1 but may be out of Network with United HMO plan 2. In addition, there are many additional options like dental and vision that can vary widely along with wide ranging co-pays and max out of pocket limits from one Medicare Advantage plan to another. When it comes to making sure you make the right decision for yourself and it's important to sit down with a professional to review your options and benefits. It's doubly important if you are seeing a primary doc or specialist that you absolutely must keep in network!

Answered by Mel Stevens on March 30, 2025

Broker Licensed in AZ

Answered by Mel Stevens Medicare Insurance Agent

Gary Haft · Answer

You can see your current doctors on a Medicare Advantage Plan if they are listed in their Provider directory and obviously must be currently on their provider network. Otherwise you will need to look for new doctors/providers within the Provider Network of that Medicare Advantage Plan. Each Advantage Plan has a different directory.

Answered by Gary Haft on June 2, 2025

Agent Licensed in FL, AL, DC & 9 other states

Answered by Gary Haft Medicare Insurance Agent

Sonya Chandler · Answer

As your Insurance Agent I would get a list of all of your current doctors.  Then we would look for a Plan that covered all of your doctors so you could keep them.

Richard Balistreri · Answer

As agents, we do a search to see what Medicare Advantage Plans your doctor participates in. The only time you would need to switch doctors is when there is not a plan that your current doctor accepts.

Douglas Carney · Answer

Whether you can keep seeing your current doctors after switching to a Medicare Advantage plan depends on the plan’s network. Most Medicare Advantage plans, like HMOs or PPOs, have a network of doctors and hospitals you must use to get the lowest costs. If your doctors are in the plan’s network, you can likely continue seeing them. However, if they’re out-of-network, you may face higher costs or need to switch doctors, especially with HMO plans that typically require in-network care except for emergencies. PPO plans offer more flexibility for out-of-network providers, but at a higher cost. Some plans, like Private Fee-for-Service (PFFS), allow you to see any Medicare-approved doctor who accepts the plan’s terms, but not all providers do.

To ensure you can keep your doctors, check the plan’s provider directory on their website or call the plan directly to confirm your doctors’ participation. You can also contact your doctors’ offices to verify if they accept the specific Medicare Advantage plan you’re considering. Always review the plan’s network rules before enrolling to avoid unexpected costs or changes in care.

Andre Cabral · Answer

A: If your doctors are in the network of your new plan, you just keep them seamlessly. Depending on your new plan, you still can see them and pay a higher co-pay as an out-of-network doctor.

Jessica Breland · Answer

That depends on the doctors & the plan. Every Advantage plan has their own network of doctors. When I am trying to find an Advantage plan for someone the goal is for that plan to cover all of their RXs at the lowest cost & all current doctors are in network. Be sure the agent you see checks everything before you enroll in a plan.

Answered by Jessica Breland on April 14, 2025

Broker Licensed in LA

Answered by Jessica Breland Medicare Insurance Agent

Can I keep seeing my current doctors if I switch to a Medicare Advantage plan, or do I have to find new ones?

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Can I keep seeing my current doctors if I switch to a Medicare Advantage plan, or do I have to find new ones?

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