Medicare Providers: Frequently Asked Questions
Keeping your doctors and finding quality care is a top priority when choosing Medicare coverage. This FAQ covers how provider networks work, verifying doctor participation, and what to do if your provider leaves your plan.
Common Questions
Can I keep my current doctor with Medicare?
With Original Medicare, you can see any doctor who accepts Medicare (over 90% do). With Medicare Advantage, you'll need a plan that includes your doctor in its network. Always verify before enrolling.
How do Medicare Advantage networks work?
MA plans have networks of contracted providers. HMOs require using in-network providers except for emergencies. PPOs cover out-of-network care at higher cost. Verify your doctors and hospitals are in-network before enrolling.
Do I need a referral to see a specialist?
With Original Medicare, no referral is needed for any specialist. Medicare Advantage HMOs typically require referrals from your primary care doctor. PPOs usually don't require referrals even for specialists.
What if my doctor leaves my Medicare Advantage network?
If your doctor leaves your plan's network mid-year, you may qualify for a Special Enrollment Period to switch plans. Contact your plan to understand your options and any continuity of care provisions.
How do I find doctors who accept Medicare?
Use Medicare.gov's Physician Compare tool to search for Medicare-participating doctors. For Medicare Advantage plans, use each plan's provider directory. Always call the doctor's office to verify they're accepting new Medicare patients.
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