How Do I Change Doctors Under Medicare?

Depending on what type of coverage you have, changing doctors under Medicare will require different steps.

If you have Original Medicare (Parts A and B) and a Medicare Supplement plan:
With this coverage, you can go to any doctor or provider who accepts Medicare patients. It is always a good idea to call the doctor’s office and verify that he or she will accept new Medicare patients before you make an appointment.

If you have a Medicare Advantage HMO plan:
In most cases, this type of plan requires you to see doctors within the plan’s network. HMO plans have a list of doctors who are in the plan’s network – this list can be found on the plan’s website or you may request a printed copy. To change your primary care doctor, you will need to contact your insurance company either by phone or sometimes through their website. After selecting a new primary care physician, the plan should send you a new ID card listing the doctor on it.

If you have a Medicare Advantage PPO plan:
This type of plan also has a list of doctors within the network, however you have the flexibility to see doctors outside of the network (at a higher cost share). To change your doctor, you don’t typically need to contact the insurance company, but keep in mind the cost differences for in-network versus out-of-network. It is always a good idea to call the doctor’s office and verify that he or she will accept new patients.

For more information about Medicare, contact us at (941) 405 – 3900.