Fifty-seven percent of seniors are currently enrolled in a Medicare Advantage plan instead of original Medicare with a Medicare Supplement (Medigap). Unlike original Medicare with a Medicare Supplement, folks on Medicare Advantage must follow the rules of the individual private insurance company that manages their plan.
Seniors on Medicare Advantage plans are usually in one of two types of plans:
When doctors leave a Medicare Advantage plans’ network in the middle of the year, it often leaves seniors struggling to find new doctors fast.
When you try to establish yourself as a new patient at a new doctor, it can mean long waiting times to get an available appointment. For example, it recently took my friend over four months to get an appointment to see her new primary care doctor. She called in early August, and she couldn’t be seen until after Christmas.
Medicare Advantage network changes mean you may have a decrease in continuity of care because you’re starting all over again to build relationships with new doctors, delays to see in-network doctors may occur, and potentially your new doctor doesn’t know your entire medical history like your old one.
Most folks see changing networks when you can’t change Medicare Advantage plans as more than a minor inconvenience. They see it as harmful to their overall health. So, folks proposed a new rule to allow you to change Medicare Advantage plans if your doctors went out of the network in the middle of the year.
However, Dr. Oz and Medicare did not agree to create a Special Election Period in 2027, to allow seniors to change their Medicare Advantage plan if their current doctors and hospitals left the network in the middle of the year.
Perhaps, Medicare and Dr. Oz thought too many people would change plans, and they didn’t want Medicare overwhelmed with paperwork. Perhaps, they thought people would lie about their doctors to change plans if they didn’t like their plan for other reasons. Perhaps, they thought Medicare Advantage plans wouldn’t make enough money to stay viable if they had to deal with lots of people changing their plans mid-year due to network changes.
But regardless of the reason, Medicare still will not let you change doctors if you preferred doctors leave your Medicare Advantage plan’s network.
For this reason, at the Senior Savings Network, we encourage you to look at the cost to see your go-to doctors in and out of the network when you are considering a Medicare Advantage plan in 2027. Assume the changes you make between October 15- December 7, will be for the entire year.
If you move out of your plan’s service area, or you have another special election period, you can still change Medicare Advantage plans in 2027, but it can’t be simply because your favorite doctors and hospitals leave your plan’s network.
