I changed my plan during Open Enrollment and now I can't see my regular specialist. Isn't this what the whole review period is supposed to prevent?
Answered by 23 licensed agents
Answered by Bruce Kern on April 1, 2025
Broker Licensed in NJ, AZ, CO & 13 other states
Answered by Gary Church on May 31, 2025
Broker Licensed in Ca, AZ, NV & TX
Because of this issue, CMS created the Open Enrollment Period (Jan 1 - Mar 31) where you can once again make a change to your Medicare Advantage plan.
If you made your initial change during the Open Enrollment Period then you will need to wait until end of the year during the AEP (Annual Election Period) to make a change for the following year.
Answered by Jennifer McDonnell on May 26, 2025
Broker Licensed in MI, AZ, CA & 10 other states
Answered by Robert Moore on May 28, 2025
Broker Licensed in IN, AL, IL & 11 other states
Answered by Alondra Arce on May 9, 2025
Agent Licensed in CA, AL, AR & 14 other states
The industry is constantly changing, so your agent must stay up-to-date on all other happenings in this specific industry.
Answered by Hope Suhr on May 21, 2025
Broker Licensed in CA, AZ, MO & OR, SC, TN & TX
If you worked with an agent or broker, they should have verified that all of your doctors were in the network.
It could be as simple as the doctor falling out of network after you signed up, or the company website showing the doctor in network when the doctor isn't. I have had both of these scenarios happen to a few of my clients
Answered by Diana Garner on May 2, 2025
Broker Licensed in KY, FL, IN, OH & TN
Answered by Steven Lovell on May 27, 2025
Broker Licensed in GA, CA, FL & 7 other states
WHO changed your plan? You? Or did an agent assist?
I'm not sure what you are referring to as a "review period." Are you talking about the Jan/Feb/Mar enrollment window?
Without some clarification, I'm afraid I can't help more than asking more questions back.
Answered by Frank Adkisson on April 1, 2025
Broker Licensed in NE, AR, AZ & 13 other states
While Open Enrollment allows you to choose or change your plan, it doesn't guarantee that your preferred doctors or specialists will be in-network with every available plan.
Here's a breakdown of why this can happen:
1. Network Changes:
Insurance plans have networks of doctors and hospitals they contract with.
These networks can change from year to year, meaning a doctor who was in-network last year might not be this year, or vice versa.
Even if a plan has the same name as last year, its network might have changed.
2. Plan Choices:
During Open Enrollment, you have the opportunity to review different plans with varying networks and coverage options.
Choosing a plan with a different network than your previous one might mean that your specialist is no longer considered "in-network".
3. The Purpose of Open Enrollment:
Open Enrollment is designed to allow you to evaluate and choose a plan that best fits your needs and budget, but it requires you to research and compare options carefully.
It's a time to consider your overall healthcare needs and preferences, including whether having a specific doctor in-network is a priority for you.
What can you do?
Contact your insurance company: Confirm if your specialist is in-network or out-of-network with your current plan and understand the cost differences.
Look for a new in-network specialist: You may need to find a new specialist who is part of your plan's network.
Consider a plan change during the next Open Enrollment: Evaluate plans based on your healthcare needs and provider networks before making a decision for the following year.
In some cases, you might be able to request an exception to see your specialist if they are out-of-network but provide unique care.
Answered by Fred Manas on May 19, 2025
Agent Licensed in NY, CT, DC & 7 other states
Answered by Steve Brauer on April 8, 2025
Broker Licensed in AZ & CA
If you purchase a Medicare supplement plan, then you don't have to worry about that because Medicare supplement plans to work with anyone who takes Medicare. Therefore, they cannot tell you that they're not taking your plan because you're out of network. There is no such thing
This is why I recommend Medicare supplement plans if you can afford them
Answered by Gary Henderson on May 19, 2025
Agent Licensed in TX, AK, AL & 46 other states
Answered by Andrew Kramer on May 23, 2025
Agent Licensed in FL
Answered by Sam Silva on June 3, 2025
Broker Licensed in FL, GA, NJ & 7 other states
Answered by Larry Pereiro on April 28, 2025
Agent Licensed in IN
I'm assuming you gave the person that you were speaking with about your healthcare information on your specialist's. And this person said "they are in network". And off you go completing the application thinking that everything is perfect and then when you go to the doctor's office you show on the card, and unfortunately they do not accept it.
What do you do? You can get that person on the phone to see if they can help you, you can try the insurance company to see if they can help you, or you can pick any of the five+ brokers who have answered your question.
You have an answer faster with the 5 plus brokers then with your insurance company, and then on top of trying to get a hold of that guy that signed you up back in AEP.
Answered by Robert Simm on April 9, 2025
Broker Licensed in NC, AL, AR & 15 other states
Answered by Karen Ansell on April 22, 2025
Agent Licensed in FL, GA, KY & OH
Answered by Tony Hardwick on April 28, 2025
Agent Licensed in GA, AZ, CA & 15 other states
Answered by Todd Bostic on June 2, 2025
Broker Licensed in TX, AL, AZ & 12 other states
Answered by Ellen Diehl on April 5, 2025
Broker Licensed in GA
Answered by Fran Lovelace on May 4, 2025
Agent Licensed in NC, SC & VA
Answered by Sophia Davis on May 1, 2025
Agent Licensed in OH
Medicare Open enrollment is from 1/1 to 3/1 for those who enroll in a Medicare advantage plan. They will have one time chance to switch to the new plan. Once used, it will become unavailable. This is for someone who switch to a new Medicare Advantage plan during the Annual Election Period to see if it works for them and provide them a chance to amend.
Answered by Charles Mai on May 26, 2025
Broker Licensed in NJ, CA, FL & 6 other states
Tags: Coverage Enrollment Periods
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