I have heard of some people's providers dropping their Medicare Advantage plans. Should I be worried about this?

Question

Stuart Graham · Accepted Answer

Yes, this has become more of an issue lately because of inflation and the impact of the IRA on insurance companies and providers. However, it is still a relatively small issue in the grand scope of Medicare Advantage. Many plans maintain great networks and network outages are many times short lived.

Answered by Stuart Graham on June 30, 2025

Broker Licensed in GA, AL, LA, MS, SC & TN

Answered by Stuart Graham Medicare Insurance Agent

Steve and Sue Brauer · Answer

So the question is, someone has heard of other people's providers, insurance companies dropping the Medicare Advantage plan. Should you be worried about this? Well, I'm here to tell you I've been doing insurance a long time. This happens with insurance carriers in every segment, whether it's individual plans like the Obamacare marketplace plans or group health plans, all of it. Nothing is for certain with these insurance companies. The good thing is there are some stop gaps in place, so if an insurance company goes out of business or if they stop offering plans, that gives people what's called a special enrollment period to move into another one. If that happens—and it does happen, not all the time, but it does happen—have your Medicare advisor help you with that, and they will move you into a plan, maybe even a better plan, depending on what conditions you have and what works for you.

George Ibanez · Answer

Providers are dropping Medicare Advantage plans by the thousands since they are not getting paid enough by the insurance carriers providing Medicare Advantage plans.
I would advise anyone who can afford a traditional Medicare supplement plan to switch immediately to avoid the risk of losing their doctor and their hospital.

George Ibanez 
Contact me.

Mark Maliwauki · Answer

We are all waiting to see what is going to happen for 2027. At this point, we have no information that would suggest that Med Advantage plans will be dropped. Typically, the Med Advantage plans that have been dropped are for many of the following reasons:

1. Pulled out of a county or even a state
2. Dropped PPO and kept HMO plans
3. Reduced Med Advantage plan benefits to make sure the plans are profitable

2025 and 2026 were driven by the Inflation Reduction Act from the Biden Administration. The elements of that Act will go through at least 2027.

Bill Wheeler · Answer

Things change every year. Don't worry. If there is to be an occurrence such as that, you would be notified in time to make a change to another provider.

Edward Smith, ChFC, CRPS, AIF · Answer

Since Medicare Advantage plans use networks, this can happen. If you are concerned about this, you could do one of two things. You could make sure you go with a PPO plan, so that even if the facility were to drop out of the carrier's network, there would still be some out of network coverage. Secondly, you could consider purchasing a Medicare Supplement plan. These plans do not use network and allow you to see any doctor or go to any facility that accepts original Medicare. I hope this helps.

Answered by Edward Smith, ChFC, CRPS, AIF on June 30, 2025

Broker Licensed in OH, GA, IN, KY & TN

Answered by Edward Smith, ChFC, CRPS, AIF Medicare Insurance Agent

Kerwyn Jones · Answer

If you have a Medicare Advantage Plan, it more likely because of a myriad of reasons. providers find it easier to work with Original Medicare.

Sandra Teel · Answer

Yes and No.  Every insurance company goes through "contracting" with local medical groups.
This is usually done every few years.  Most of the time the insurance company and the medical groups come to an agreement and there is no interruption to your service.  Sometimes however, they do not come to an agreement by a specific time frame and that medical group is "out" of the insurance companies' network.
If you have an HMO plan this will affect you greatly, as you will no longer be able to see your doctors in that medical group. The HMO insurance company will reassign you to another in network medical group.  This can be very distressing.  It doesn't happen often, but it does happen. 
If you had an Advantage PPO plan, you might still be able to see your "out" of network doctor at the out of network price.  
This is something you should consider when you are choosing an Advantage plan

Jennifer Melancon · Answer

When you decide to opt out of original Medicare and go onto an advantage plan then you must understand that the plans are always changing and you will need to review your plan yearly. Providers are not locked in for the year, they are allowed to stop taking plans on a monthly basis. Therefore if your provider decides to stop taking a particular advantage plan then Yes, you could need to switch to another provider mid year.

Answered by Jennifer Melancon on November 19, 2025

Agent Licensed in FL & VA

Answered by Jennifer Melancon Medicare Insurance Agent

Corey Schuler · Answer

With Medicare Advantage plans, providers can leave the network at any time during the year.  You can always switch your provider to an in-network provider should this happen to you.

Kent Hoyle · Answer

If you are concerned about your Medicare Advantage policy being canceled from one year to the next, that would be a legitimate concern because that is exactly what the insurance companies can do. The companies have that prerogative; however, Medicare Supplement policies are Guaranteed for Life.

Answered by Kent Hoyle on September 27, 2025

Broker Licensed in MO

Answered by Kent Hoyle Medicare Insurance Agent

Andrew Zurbuch, MBA · Answer

No, this does happen. Just stay away from low Star rated plans & please call a Broker for assistance. There is at least 1 Insurance Company whom sells Medicare Advantage plans that does not have a good reputation with providers. Don't use that Company if your concerned regarding providers & claims. Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Frank Carta · Answer

If a provider drops your Medicare plan, I will make sure that you have a Special Enrollment 
period so that you do not lose coverage, and put you in a new plan.

Rick Boyd · Answer

Providers can move out of network any time during the year, and you should receive a 30 day notice at the minimum. If it is a critical provider, call your broker or member services to determine if there is another provider in-network that will meet the same need. If there is not a provider within the network, you may have a special election period in which you can choose another plan. PPO Advantage plans do allow for out of network providers who take Medicare but at a higher cost to the consumer.

Answered by Rick Boyd on December 8, 2025

Broker Licensed in KY, AZ, CA & OH, TN, TX & UT

Answered by Rick Boyd Medicare Insurance Agent

James Stang · Answer

You shouldn't be too worried. It can happen under certain circumstances but the carriers will usually find a way to retain the providers in the network until the end of the year so their clients can find other policies that would allow them to continue to see their preferred providers.

Answered by James Stang on July 28, 2025

Agent Licensed in OH

Answered by James Stang Medicare Insurance Agent

Hannah Skinner · Answer

It is very common for providers to leave the network of advantage plans. Provider contracts with insurance companies can end in the middle of the year where as you are bound to your Medicare Advantage plan from January 1st- December 31st in most cases. If you are in a PPO you can likely still see that provider if they go out of network, but you will pay more. If you are in a HMO, seeing an out of network provider will not be covered by the plan.

Answered by Hannah Skinner on August 18, 2025

Agent Licensed in SC, AL, AR & 44 other states

Answered by Hannah Skinner Medicare Insurance Agent

Terry Salak · Answer

Contracts between carriers and providers are not "forever" and do change often.  It is very important to look at your paper mail as this is typically the first form of communication that will let you know there are going to be changes.  

If a contract negotiation is reached between the carrier and the provider (or medical system) then your provider will remain IN-NETWORK.  

Most MAPD PPO plans will give you the option to see both in-network and out-of-network providers, with OON typically having a higher co-pay.  MAPD HMO plans will not give you this option.

In order to avoid this, I would suggest looking at Medicare Supplement plans as an option.  With a Medicare Supplement policy, you are paying an additional monthly premium, but you no longer have to worry about providers, facilities or systems being in or out of network.

Frank Woerner · Answer

Annually you will see some carriers making adjustments on Advantage plans and other programs. If a carrier does drop or change a plan in your area, they are required by law to inform you well in advance. In September of each year, you will receive an ANNUAL NOTICE OF CHANGE. (ANOC letter). Watch for it and review it. The letter will inform you if your plan is being dropped.

Answered by Frank Woerner on September 8, 2025

Broker Licensed in IN & IL

Answered by Frank Woerner Medicare Insurance Agent

Valerie Schurman · Answer

Yes some have left and some have moved to a different insurance company platform   i would recommend to talk with your doctor and find out their plans 

thanks
val

Rob Campbell · Answer

Providers may drop some of the smaller Medicare advantage companies in order to consolidate their client base into an easier to manage group. If you’re going to go with a Medicare advantage plan, you are typically going to be safe with one of the major plans i.e. UnitedHealthcare, Humana, Aetna

Answered by Rob Campbell on August 17, 2025

Broker Licensed in NC, AZ, CT & 11 other states

Answered by Rob Campbell Medicare Insurance Agent

Steve Schnell · Answer

If a provider drops a plan, you have some guarantee rights under Medicare that allow you to obtain new coverage. CMS has 7 guaranteed rights for Medicare participants.

Deborah Zanelotti · Answer

I wouldn't say worry but stay aware of any changes with your Med Adv plan by reading any correspondence received from your carrier and in a timely manner. If there is a change, of no fault of your own, you will have SEP (Special Enrollment Pd) but for a short window. Your particular situation would need to be discussed with a licensed agent familiar with your rights should your carrier discontinue the plan you are enrolled in.

Answered by Deborah Zanelotti on March 23, 2026

Agent Licensed in MD, CA, DC & 11 other states

Answered by Deborah Zanelotti Medicare Insurance Agent

Chuck Winderl · Answer

No there are several very good companies to select from. I am a licensed certified Humana agent and Humana is one of the top if not the top company for Meficare Advantage plans

Fred Manas · Answer

Yes, you should be aware of the possibility of your Medicare Advantage plan dropping providers and how it could affect your care. While many people find Medicare Advantage plans to be a good fit, some providers are leaving these plans due to issues like low reimbursement rates or administrative burdens, according to multiple sources. This could lead to disruptions in your care if your current doctors or hospitals are no longer in your plan's network. Here's why you should be concerned and what you can do:
Provider Network Changes: Hospitals and doctors can choose to leave a Medicare Advantage plan's network, meaning you might need to switch providers or pay more to stay with your current one. Potential for Increased Costs: If your preferred doctor is no longer in your plan's network, you might have to pay out-of-pocket to continue seeing them, or switch to a different doctor within the network, according to Triage Cancer.  Disruptions to Care:
Losing access to your preferred providers can disrupt your care, especially if you have ongoing treatments or complex health needs.  "Guaranteed Issue" Period Limitations:
Switching back to Original Medicare after leaving a Medicare Advantage plan can make it difficult to find an affordable Medigap plan, especially if it's been more than six months since you first enrolled in Medicare Part B.  CMS Guidelines: The Centers for Medicare & Medicaid Services (CMS) has emphasized that Medicare Advantage plans must notify members of significant network changes, and members should have access to counseling to help them make informed decisions. What you can do: Check your plan's network:
Review your plan's provider directory to see if your current doctors and hospitals are still in the network. Consider switching plans: If your current plan is dropping providers you need, explore other Medicare Advantage plans or consider switching back to Original Medicare during the Open Enrollment Period (October 15 – December 7) or during a SEP.

Vachik Chakhbazian · Answer

If your doctor leaves your plan's network, you may need to find a new in-network provider, which could involve searching for doctors and potentially disrupting your care, especially if you have a chronic condition. Seeing a doctor outside of your plan's network might result in significantly higher out-of-pocket costs or even no coverage at all, depending on your specific plan. Medicare Advantage plans can have complex prior authorization processes and sometimes delay payments to providers, making it difficult for them to manage their practices.

Answered by Vachik Chakhbazian on June 30, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Gary Henderson · Answer

If you have not received a notice, then your plan would renew automatically for 2026. If you have concerns, call the customer service number. If they are dropping the plan you have gauranteed issue rights, which allows you to change plans within 63 days. Plan would end on Dec 31, 2025 unless notified otherwise.

Answered by Gary Henderson on October 8, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Carol Thompson · Answer

It can be concerning , I can suggest you to inquire with your drs office when you have an appointment and see what plans they will stay with. Often times they will even tell you why they are dropping the plans. Good luck!

Answered by Carol Thompson on October 14, 2025

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

Answered by Carol Thompson Medicare Insurance Agent

Suzanne Lamperti · Answer

Medicare Advantage Plans have a cheaper premium(s). Medicare plans give the participants more choices than Medicare Advantage Plans. Medigap plans are also less restrictive.

Jack Mayer · Answer

Too much utilization and Medicare will only pay so much yet healthcare rises every year so all Medicare Advantage plans re negotiate with providers yearly and sometimes they can't come to an agreement. You will never worry about that when you have original Medicare and a Med-Supp that said if you lose your provider you would need to find a new PCP or health plan with a special election period if needed, so if there is no provider available you can change plans outside of AEP and OEP

Answered by Jack Mayer on March 16, 2026

Agent Licensed in CA & NV

Answered by Jack Mayer Medicare Insurance Agent

Pat Papson · Answer

Hello.. every year certain companies change plans, and sometimes change plan they offer in different counties 

If that should happen in your community, you will have ample to time to choice another plan.

Just contact a local Agent to help navigate the best plan for you.

Hope this helps..

Jaye Maxx Alexander II · Answer

You don't need to worry, you can always find another PCP in the same practice. If your PCP chooses to drop from a Medicare Advantage HMO group. Your options are to call and find another PCP in the Medicare Advantage program or to pay out of pocket to continue seeing the provider if they accept original Medicare.

Answered by Jaye Maxx Alexander II on August 11, 2025

Broker Licensed in NC, AK, AL & 47 other states

Answered by Jaye Maxx Alexander II Medicare Insurance Agent

Michael Kim · Answer

No. Most Medicare Advantage Plan carriers will have have alternative plans if this ever happens. And if the carrier is no longer available in the area I would just offer you another carrier as I am a Medicare Insurance Broker appointed with most major carriers in your area. I'm licensed in 24 different states.

Answered by Michael Kim on November 10, 2025

Agent Licensed in NV, AR, AZ & 18 other states

Answered by Michael Kim Medicare Insurance Agent

Don Hansford · Answer

I don’t think worried is the right label, more that you just need to be aware that providers can drop or add networks throughout the year. If this does happen to you, you will have the option to select another provider or if the situation was deemed a major change in the network, CMS may provide a Special Enrollment Period for you to change plans.

Answered by Don Hansford on February 16, 2026

Broker Licensed in TX

Answered by Don Hansford Medicare Insurance Agent

Cheryl Lyons · Answer

It can happen, but it’s usually not something to panic about — it’s a normal part of the Medicare Advantage (MA) landscape. Here’s what you need to know:

Why providers drop MA plans

Network contracts change – Insurers renegotiate with doctors and hospitals yearly.

Financial or administrative reasons – Some providers decide the reimbursement rates or paperwork aren’t worth it.

Plan changes – Your MA plan may change its network rules during Annual Enrollment.

What it means for you

If your primary doctor leaves the network, you may:

Pay higher out-of-pocket costs for out-of-network care (if your plan allows it)

Need to choose a new in-network provider

If your hospital leaves, elective procedures may need to be at a different facility

How to protect yourself

Check your plan’s network each year

MA networks can change January 1; your plan is required to send updates.

Ask about continuity of care

If your doctor leaves, Medicare requires some plans to provide temporary coverage for ongoing treatment.

Annual Enrollment Period (Oct 15 – Dec 7)

You can switch MA plans or return to Original Medicare + Part D/Medigap if your provider leaves.

Call your plan before procedures

Confirm that your doctor and hospital are still in-network to avoid surprise bills.

Bottom line:
Yes, it’s possible your provider could leave an MA network, but staying informed, checking networks annually, and knowing your enrollment options protects you from major surprises.

Jeffrey Sodikoff · Answer

In one word ,YES. I have never seen these many changes in the Medicare Advantage Plans for 2026 that I have ever seen over the last 30 years that I have been a licensed Medicare agent in Florida. Hospitals and doctors are leaving the networks. Well known insurance companies are pulling their plans out of the market. Out of Pocket Maximums, which is the maximum amount of money that you are financially responsible for ( excluding prescription drugs at a pharmacy ), are being increased by double digits. The good news is, that the prescription drugs you buy at a pharmacy, AND, is in your Medicare Advantage plans Drug Formulary, is capped for 2026, at a $2100 a year out of pocket maximum. Even better news, is that you can spread that annual cost over 12 months, interest free. My final recommendation from 3 decades of experience, is to work with a dedicated agent who you can reach 7 days a week on his cell phone. Working with a " call center " agent who is working for the insurance carrier is Not recommended because you have No professional relationship working in your favor. Remember, agents like myself are compensated by the insurance carrier. A dedicated insurance agent is your advocate at No cost to you. My clients that I still have for over 30 years won't let me ever retire, and some are over 90 now. I now have their children as clients.

Answered by Jeffrey Sodikoff on October 12, 2025

Agent Licensed in FL

Answered by Jeffrey Sodikoff Medicare Insurance Agent

Jim Willis · Answer

That is true.  That's why it is important to go to a local agent (not some 1-800 number on TV) who stays up on all the plans the doctors in your area and your medications.

There is no need to worry if you have a local agent who will still work to get you the plan you need.

Glenn Alterman · Answer

Yes, you should be worried 

You should have a Medicare Supplement, and I will get you a $0 premium RX, too

If you qualify, I will be glad to issue it for you

Need to know a few things, of course 

Please contact me.


Ty. 
Glenn

Lillian Hill · Answer

MAPD plans are being reduced in some areas, so it’s smart to stay alert. If keeping your current doctors is important, check with their offices to see whether they expect any network changes. You can also review your carrier’s financial stability and talk with your agent about other plan options in your area in case you ever need to switch or replace your existing coverage. 

🦉

Mark Murphy · Answer

it does happen from time to time. In most cases, if you're in a PPO plan, you'll still be able to use your provider until you can make your annual change in October. it shouldn't be a big worry but be aware that it can happen.

Answered by Mark Murphy on March 23, 2026

Agent Licensed in NJ, AL, CO & 9 other states

Answered by Mark Murphy Medicare Insurance Agent

Greg Strasma · Answer

This can happen and it is usually with smaller, local insurance providers. Personally I only sell for the national brands like Humana, Aetna and WellCare. Will these carriers drop Medicare Advantage plans? They can but usually only do that for new contract year periods that begin on January 1. Contact your Medicare Agent to inquire about this if you have been notified by your insurance carrier that they will be dropping your coverage and your Agent can help you find a replacement plan to ensure you don't have a lapse of coverage.

Answered by Greg Strasma on October 30, 2025

Agent Licensed in GA

Answered by Greg Strasma Medicare Insurance Agent

Samantha Jones · Answer

There are some doctors and medical groups that do drop their advantage plan but you just need to stay alert and know whether or not it will change

Holt Rushing · Answer

No, I wouldn't be worried about that at this time. I would have a secondary policy added to protect you from some of the higher copays though.

Tony Carlton · Answer

Thank you for this question. This is probably the most important question for Medicare Beneficiaries going into 2026.
My recommendation for you and all Medicare Beneficiaries is to have a 'Annual Review' of your plan  and the upcoming options for the coming year. I implore all Beneficiaries t review the upcoming Formulary changes for your prescriptions, doctors, and hospitals.
Because of the changes that were made in 2024, we are still feeling the effects and need to plan accordingly. Many plans around the country have been ended. So, replacing your plan is essential. For example, in the state of Vermont there is only one Medicare company available because every other company found it too stressful to remain and offer coverage. Now if your plan has been Terminated you have the opportunity to return to Original Medicare on a Guaranteed Issue basis. There will be no Pre-Existing Conditions or Underwriting for your policy.
So, find yourself an independent agent who can see the whole landscape of Medicare. A good agent is an invaluable source of expertise whose service can guide you to the plan that will save you money and save your health.
Thanks again and God bless!

Amal Sahyoun · Answer

If this happens, you are entitled to SEP (Special Election Period).

And you can join another plan that suits your needs immediately.

Roseann Vandevender · Answer

That may be the case. But if this does not need be a major concern because if they are involuntary disenrolled that will open up a SEP Special Enrollment Period for them to enroll in a new and maybe better plan for them.

Answered by Roseann Vandevender on July 14, 2025

Agent Licensed in OH, AZ, CO & TX

Answered by Roseann Vandevender Medicare Insurance Agent

Chase Punzalan · Answer

Hello! Carriers and health care providers can both choose to partner or not. Ultimately , the business decision is a two way street.

Aaron Lewis · Answer

If a provider no longer wants to participate in a Medicare Advantage plan you might be notified from the Insurance carrier and they would be able to help you find another provider in your plan . If you still want to continue seeing that out of network provider you would be responsible for his payment in full.

Answered by Aaron Lewis on June 30, 2025

Agent Licensed in NJ

Answered by Aaron Lewis Medicare Insurance Agent

Ricky Rash · Answer

Yes, and this is a growing trend that all Medicare consumers should be aware of before making a decision on what type of insurance they choose - Advantage or Supplement. If someone chooses an Advantage plan, they need to understand that both hospital and physician contracts can be entered into or terminated at any time during the year, which can spell disaster for Medicare clients who are seeking care. On the other hand, if someone purchases a Medicare Supplemental Insurance policy, he/she can seek medical care wherever they choose, so long as the provider/facility accepts Original Medicare.

Answered by Ricky Rash on January 12, 2026

Agent Licensed in FL, AL, CA & 15 other states

Answered by Ricky Rash Medicare Insurance Agent

Kathleen Emert · Answer

I believe in the upcoming year additional plans will be discontinued. You should continue to reveiw you situation and plan on an annual basis. Make sure to review all correspondence from your Medicar Advantage Carrier. If the plan is being discontinued you will receive a notification.

Answered by Kathleen Emert on June 30, 2025

Broker Licensed in NY, FL & PA

Answered by Kathleen Emert Medicare Insurance Agent

I have heard of some people's providers dropping their Medicare Advantage plans. Should I be worried about this?

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