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Can your doctor drop your Medicare Advantage plan?

I was recently asked an excellent question, and it was, “Can your doctors add or drop Medicare Advantage plans?”

This is a very important question because, as I talk about this time and time again, the most important thing, in my opinion, when it comes to making a Medicare decision, is that you can see your preferred doctors and hospitals. Knowing whether or not those doctors and hospitals accept the Medicare plan you choose is a critical first step.

I don’t believe that all doctors and hospitals are made the same, and so if you want your Medicare to work for you, I think it’s imperative to know that your doctor accepts it.

To the point of this question, yes, they can drop and add Medicare plans. So what if your doctor accepts it today, and they drop it in the future? Or vice versa?

The thing is, doctors can opt-in or opt-out of Medicare Advantage plans or even an Original Medicare plan. So there is a risk of that happening.

We tend to see the drops happen more frequently with Medicare Advantage plans than we do with Original Medicare.

Since we all don’t know what will happen in the future, my advice to those of you who want a Medicare Advantage plan is:

  1. Go into your Medicare decision knowing what Medicare Advantage plans your preferred doctor accepts.
  2. Ask yourself, if my doctor drops this, am I okay staying inside this Medicare Advantage network? If the answer is no, then am I better off on traditional Medicare that gives me a bit more wiggle room?

It’s important to remember that you can change Medicare Advantage plans once a year. And so there are times you can switch between plans if your doctor drops one Advantage Plan. However, the hard part is if your doctor drops the Advantage plans and you then want to go back to traditional Medicare with a Medigap Plan.

At that point, you may be subject to insurability rules and may not get a chance to switch from Medicare Advantage to Original Medicare.

So just be sure you’re looking at all the variables when making your Medicare decision. I don’t want you to regret it down the road.

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