📋 You Can Now Learn if Medicare Advantage Covers Your Doctor (AARP Article)

[Fall2025VA]

FROM THE ARTICLE.

Providers for Medicare Advantage Plans Now Listed on Medicare Plan Finder.

Part D prescription plans will have pharmacy cost comparisons.

By Tony Pugh, AARP. Published October 08, 2025.

Key takeaways!

[*] More details on Medicare Advantage plans come to plan finder.

[*] Participating provider lists should be ready for open enrollment.

[*] If the info is wrong, you’ll have 3 months to change plans.

[*] Other special enrollment periods could work for you.

[*] Details on supplemental benefits, pharmacies also available.

The federal government’s main tool that enables consumers to compare Medicare Advantage plans and Part D prescription drug plans is getting some notable improvements for the 2026 coverage year.

And enrollees could get a do-over if the effort backfires.

USE LINK BELOW TO READ THE ARTICLE.

https://www.aarp.org/medicare/medicare-plan-finder-provider-listings/

[CBtoo · Accepted solution]

Unfortunately what I am hearing from agents on that list I am on (I am not an agent) is that the multiple sources of information they have access to don't agree (both saying they are in network and out of network) and that what they are telling clients is that it would be prudent to call the offices of the doctors that matter to you to find out if they are in network if you are signing up for an advantage plan. Hopefully they will get everything fixed before we are too far into our sign up period and especially for the advantage plan sign up in Jan.

For original medicare any doctor or system anywhere that takes medicare will see you. With advantage plans the doctor or system needs to be in network for you to pay the least.  

[TRL1111]

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@CBtoo wrote:

For original medicare any doctor or system anywhere that takes medicare will see you. 

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More accurately, Medicare will pay for services you receive from them.  But they don't have to agree to see you.  For example, some providers will continue to see patients they already have who transition from private insurance to Medicare when they turn 65, but won't accept new patients who are on Medicare.

[GailL1]

@TRL1111 

From what I am hearing, this is happening more and more everyday - we do need a lot more PCP - of some variety that will take Medicare patients cause a lot of them are either retiring now or they want to limit their practice in Medicare patients ( MA or Traditional)

[GailL1]

Keeping their network list correct is hard for MA plans because their contracts don’t last as long as those for Traditional Medicare.  It still can happen in traditional Medicare but not as much since most docs do Re-up their participation.  OR they may go from accepting assignment to non-participating and thus the beneficiary is informed up front.  

If a beneficiaries finds that the info on the Medicare site is incorrect in the MA provider list and it has affected their enrollment, they can ask for a Special Enrollment Period so that they will get another choice for their coverage.

[CBtoo]

Be aware that if SunFire (who medicare.gov contracted this to for who is in or out of network in an advantage plan) is wrong you only have 3 months to sign up for a new plan. Wait any longer and you are out of luck. If I were you I'd print or screenshot the provider list when you sign up in case you need to prove SunFire listed the person/system as in network.

The other problem (and for this one you are out of luck) is that doctors/systems can drop out at any time. If they were in network at the sign up period and dropped out later you have no recourse.