Medicare Annual Enrollment: How to Check That Your Doctor Still Takes Your Plan
Every fall, Medicare patients receive information about premiums, prescription coverage, benefits, and plan changes for the coming year. With so much to compare, one important question can easily get lost in the paperwork: Will I still be able to see my doctor?
Medicare Open Enrollment runs from October 15 through December 7 each year. During this period, people with Medicare can make certain changes to their health and drug coverage, including switching Medicare Advantage plans or moving between Original Medicare and Medicare Advantage. Changes made during the 2026 enrollment period generally take effect January 1, 2027. Medicare confirms these dates for the 2027 coverage year.
If you are reviewing Medicare annual enrollment 2027 options, checking your doctors should be part of that review. A plan may offer appealing benefits or lower costs, but changing coverage can also affect the physicians, specialists, hospitals, pharmacies, and medical groups available to you.
At Mayflower Medical Group, we understand how important continuity of care can be. Before you make a change, here is how to check whether your current doctor will still participate in the plan you are considering.
When Is Medicare Annual Enrollment for 2027?
Medicare Open Enrollment for 2027 coverage runs from October 15 through December 7, 2026. Changes made during this period generally begin January 1, 2027.
During Open Enrollment, depending on your current coverage, you may be able to:
● Switch from one Medicare Advantage plan to another
● Join or change a Medicare prescription drug plan
● Move from Original Medicare to Medicare Advantage
● Move from Medicare Advantage back to Original Medicare
Medicare recommends comparing your current coverage with other available options before making a change.
Review Your Annual Notice of Change
Before Open Enrollment begins, Medicare Advantage and prescription drug plans send members an Annual Notice of Change, often called an ANOC.
The ANOC explains changes to the plan that will take effect in January, including changes involving coverage, costs, and other plan details. Medicare says plans generally send this notice in September.
Reviewing it is a good starting point, even if you are satisfied with your current coverage. However, it should not be the only thing you check if keeping your doctor is important. You should still confirm whether your physicians and other healthcare providers participate in the plan you will have next year.
Why Can Your Doctor’s Medicare Participation Change?
Original Medicare and Medicare Advantage do not always work the same way when it comes to choosing healthcare providers.
With Original Medicare, you can generally receive covered care from doctors and hospitals throughout the country that take Medicare.
Medicare Advantage plans are offered by private insurance companies approved by Medicare, and many rely on specific provider networks. Medicare notes that in many cases, patients enrolled in Medicare Advantage can only use doctors who participate in the plan’s network.
The rules can also depend on the type of Medicare Advantage plan.
HMO Plans
With an HMO, you generally need to receive routine care from doctors, hospitals, and other healthcare providers within the plan’s network, with limited exceptions. Medicare also notes that HMO plans commonly have more restrictive network rules.
PPO Plans
PPO plans generally offer more flexibility. Patients can typically use providers within the plan’s network and may also be able to receive care outside the network, although out-of-network services can cost more.
That is why asking:
“Does my doctor accept Medicare Advantage?”, may not always produce a complete answer.
A medical practice may participate with an insurance company without participating in every Medicare Advantage plan or network that company offers. Some Southern California Medicare Advantage arrangements may also involve a particular medical group or Independent Practice Association, commonly called an IPA.
Provider networks can change as well. A doctor who participates in your plan this year may not necessarily have the same network status next year, which makes Open Enrollment a useful time to verify your coverage before making a decision. Medicare specifically recommends asking whether your doctors and pharmacies participate in a plan’s network before joining.
How Do You Check Whether Your Doctor Accepts Your Medicare Plan?
If keeping your current doctor is important, check their participation before you enroll in or switch to a new Medicare Advantage plan.
The insurance company’s name alone may not be enough. Start with the exact plan you are considering.
Before you begin, have the following information available:
● Full name of the Medicare plan
● Whether the plan is an HMO, PPO, or another Medicare Advantage plan type
● Your current insurance information
● Name of your primary care physician
● Medical group or IPA, if applicable
● Names of specialists you regularly see
Then work through these steps.
1. Review the Plan’s Provider Directory
Check the provider directory for the exact Medicare Advantage plan you are considering.
Do not assume that because a physician accepts one plan from an insurance company, they participate in every Medicare Advantage network offered by that carrier.
Medicare recommends checking directly whether the physicians and pharmacies you want to use are included in the plan.
2. Confirm With Your Doctor’s Office
After checking the directory, contact your doctor’s office and provide the full plan information.
Instead of simply asking:
“Do you take this insurance company?”
Ask whether your specific physician participates in the exact Medicare Advantage plan and network you are considering.
For Mayflower patients, useful questions include:
● Is my Mayflower physician in this plan’s network?
● Does the plan include the Mayflower location I use?
● Does my plan require a particular medical group or IPA?
● Will I need referrals for specialists?
● Is this information for coverage beginning January 1, 2027?
That extra detail can help prevent confusion between an insurance carrier and the specific network attached to a particular plan.
3. Verify the Medical Group or IPA, If Applicable
In some Medicare Advantage arrangements, particularly HMO plans, your primary care physician may participate through a medical group or IPA.
If your plan uses one, confirm that the medical group associated with your physician matches the one available through the plan you are considering.
4. Check Again Before You Enroll
If keeping a particular physician is essential to you, consider confirming the information with both the plan and the provider’s office before completing enrollment.
Medicare Advantage networks can change, so checking directly gives you the best available information when you make your decision.
What Else Should You Check Before Changing Medicare Plans?
Keeping your doctor may be one of your biggest priorities, but it should not be the only factor you review.
Before changing plans, consider:
● Specialists: Are the physicians you regularly see still in-network?
● Hospitals and facilities: Does the plan include the hospitals and facilities you prefer?
● Prescription medications: Are your medications covered, and what will they cost?
● Referrals: Will the new plan require referrals for specialty care?
● Out-of-pocket costs: Compare deductibles, copays, coinsurance, and maximum out-of-pocket limits.
● Pharmacies: Make sure the pharmacies you use participate in the plan when network rules apply.
● Other benefits: Compare dental, vision, hearing, transportation, or other benefits that matter to you.
Medicare recommends looking beyond the monthly premium and reviewing prescriptions, providers, pharmacies, benefits, and overall costs when comparing plans.
A plan that works well for one person may not offer the same combination of providers, medications, costs, and services for another.
Keeping Your Mayflower Doctor During Medicare Annual Enrollment
For many older adults, a primary care physician becomes familiar with much more than what appears in a medical chart. Your doctor may know your medications, chronic conditions, past treatments, specialists, and the health concerns you have been managing over time.
That relationship can be an important consideration when comparing Medicare plans.
Patients looking for Medicare doctors at our Anaheim, Covina, El Monte, La Puente, and West Covina locations should look beyond whether a physician generally accepts Medicare. If you have or are considering Medicare Advantage, confirming the exact plan, network, and medical group can help you understand whether your current care arrangement is expected to continue.
Mayflower Medical Group currently lists Medicare among its accepted insurance options. Patients can review our accepted insurance information as a starting point, but because individual Medicare Advantage plan networks can vary, contacting the office with your exact plan information is an important additional step.
Annual Enrollment is also a good time to think about your broader healthcare needs. Mayflower provides geriatric care for older adults across Anaheim, Covina, El Monte, La Puente, and West Covina, including care for health conditions that may become more common or complex with age.
Medicare Annual Enrollment gives you an opportunity to reconsider your coverage, but you do not have to make that decision based on premiums or extra benefits alone. Before December 7, confirm the exact plan you are considering, check whether the doctors and specialists you want to keep participate in its network, and verify your medical group or IPA when applicable.
At Mayflower Medical Group, our team is committed to helping older adults and their families maintain access to quality, comprehensive care. If keeping your Mayflower physician is important while you compare Medicare coverage for 2027, review our accepted insurance information and contact your Mayflower office with your specific plan details before making a change.
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