How do Medicare Advantage networks work — can I keep my doctor?
Last updated Jul 21, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Medicare Advantage plans use provider networks, so whether you can keep your doctor depends on the plan type and whether that specific doctor is contracted with that specific plan for the coming year. HMOs generally cover only in-network doctors except for emergencies and urgent care; PPOs cover both in- and out-of-network care but charge more out of network; Private Fee-for-Service (PFFS) plans and some Special Needs Plans (SNPs) have their own rules. CMS lists each plan's provider directory on Medicare Plan Finder, and networks can change annually.
Also asked as
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What it means
- A doctor 'accepting Medicare' is not the same as being in a specific Medicare Advantage plan's network.
- Emergency and urgent care are covered nationwide regardless of network on every Medicare Advantage plan.
- Provider networks can change on January 1 — always confirm for the coming plan year.
Action steps
- Print the plan's provider directory and search each of your doctors by name and NPI.
- Call the doctor's office directly and ask if they are contracted with that plan for the coming year.
- If your doctor leaves the plan mid-year, CMS may allow a Special Enrollment Period — call 1-800-MEDICARE to confirm.
Risks & deadlines
- Out-of-network care in an HMO is usually not covered, meaning you pay 100% of the bill.
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Last verified: 2026-07-21