I have heard of some people's providers dropping their Medicare Advantage plans. Should I be worried about this?
Answered by 12 licensed agents
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.
Answered by Andrew Zurbuch, MBA on June 30, 2025
Broker Licensed in IN, FL, KY, MO, OH & TN
Answered by Edward Smith, ChFC, CRPS, AIF on June 30, 2025
Broker Licensed in OH, GA, IN, KY & SC
Answered by Holt Rushing on June 30, 2025
Broker Licensed in MS, AK, AL & 29 other states
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
Answered by Sandra Teel on July 3, 2025
Broker Licensed in WV, AZ, CA & 13 other states
Answered by Corey Schuler on July 28, 2025
Broker Licensed in TX, AL, AR & 16 other states
Answered by Stuart Graham on June 30, 2025
Broker Licensed in GA, AL, LA, MS, SC & TN
Answered by James Stang on July 28, 2025
Agent Licensed in OH
Answered by Aaron Lewis on June 30, 2025
Agent Licensed in NJ & NY
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.
Answered by Fred Manas on June 30, 2025
Agent Licensed in NY, CT, DC & 7 other states
Answered by Vachik Chakhbazian on June 30, 2025
Agent Licensed in CA, AL, AR & 22 other states
Answered by Roseann Vandevender on July 14, 2025
Agent Licensed in OH, AZ, CO & TX
Answered by Kathleen Emert on June 30, 2025
Broker Licensed in NY, FL & PA
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