Changing Doctors and Networks During AEP

Doctor networks can shift year to year. Before AEP ends, verify your doctors are in-network for your 2026 plan, or switch to one where they are.

How doctor networks change

Every year, doctors may join, leave, or change their Medicare Advantage or Medigap status. A doctor you see on your 2025 plan might not be in-network for 2026.

This is especially common with Medicare Advantage plans (HMOs and PPOs have tighter networks). Original Medicare + Medigap gives you any doctor who accepts Medicare, so network changes don't affect you.

Checking networks before AEP ends

Before December 7, call your doctor's office and ask: 'Will you accept [plan name] in 2026?' Don't rely on a provider directory — call directly.

Use Medicare.gov's plan finder tool. Enter your doctor's name and NPI (from their website or your insurance card). The tool shows which plans include them.

If your doctor leaves your plan

If your current plan's 2026 network drops your doctor, use AEP to switch to a plan where they're in-network, or switch to Original Medicare + Medigap, which has no network limits.

You have until December 7 to switch plans for January 1 coverage. After December 7, you're locked in unless your doctor's departure qualifies you for a Special Enrollment Period.

Special Enrollment Period for network loss

If your doctor leaves your plan's network after you've enrolled (Jan 1 – Dec 31), you may qualify for a Special Enrollment Period to switch plans without waiting for next AEP.

You must request the SEP within 60 days of receiving notice of the network change. Act quickly — SEP windows are time-limited.

Frequently asked questions

How do I know if my doctor is in-network for a Medicare Advantage plan?

Call the doctor's office or use Medicare.gov's plan finder tool. Enter the doctor's name and the plan name to confirm.

What if my doctor is dropping Medicare entirely?

You'll need a new primary care doctor if you stay on Medicare Advantage, or switch to Original Medicare + Medigap, which lets you keep any doctor accepting Medicare.

Can I see my out-of-network doctor if I have Medicare Advantage?

Generally no, unless it's an emergency. Out-of-network care is usually not covered. This is why verifying networks before enrollment is critical.

If my doctor leaves mid-year, what's a Special Enrollment Period?

It's a limited-time window (usually 60 days) to change plans outside of AEP. You must notify Medicare within 60 days of the network change to qualify.

General educational information only, not medical or legal advice. Medicare plan networks, doctor status, and Special Enrollment Periods vary. Verify current information directly with Medicare and your doctors.

Related articles