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How to change doctors if you are on Medicare
December 17, 2020 at 8:00 AM
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How you choose your primary care provider ultimately depends on what kind of Medicare plan you have.

If you have Original Medicare, for example, you can simply visit any care provider that accepts Medicare patients. Medicare Advantage plans, on the other hand, vary based on whether you have HMO or PPO insurance. Either way, with this option, your best bet is to work with a doctor in your plan’s network.

Here, we’ll take a closer look on how to change your doctor, depending on what Medicare health insurance plan you have.

How to change doctors if you have Original Medicare and a Supplement plan

As mentioned earlier, Original Medicare gives you lots of options. You can choose any doctor you prefer, as long as they accept Medicare patients.

Of course, it’s best to confirm with your doctor to confirm they accept Medicare insurance before you go in for your appointment.

How to change doctors if you have a Medicare Advantage plan

If you have an HMO plan, you’re usually required to choose a primary care provider in your network. If you need to see a specialist for any health concerns, you’ll need a referral from your doctor to do so.

To choose your doctor, you can simply visit your plan’s website or call your insurance company for a list of in-network providers. Making the switch entails calling your insurance or filling out a change form on the website. Once you’ve notified your insurance company about the change, they will send you an updated ID care with the name of your new doctor on it.

On the other hand, a Medicare PPO plan works much like other PPO plans. You have the freedom to choose a doctor within your network, or pay a higher cost share to see someone that’s not on your insurance plan’s list of in-network doctors.

Another difference between Medicare’s PPO and HMO plans is that, with a PPO plan, you aren’t required to update your insurance company when you switch providers. You also don’t need a referral to see a specialist for any health issues.

But similar to those who have Original Medicare, you’ll want to confirm that your new care provider accepts Medicare patients before you go.

Enrollment periods for Medicare Advantage plans

It’s important to note that, if you’d like to switch between Medicare Advantage plans or move from one to an Original Medicare plan, you can do so between January 1st and March 31st of every year.

This is in addition to the usual open enrollment period that opens up at the end of every year, from October 15 to December 7.

However, you can’t go from an Original Medicare insurance plan to a Medicare Advantage plan during the January 1 - March 31 period. If this is something you’re looking into, you’ll have to wait until the open enrollment period comes back around again.

If you have any additional questions about your health insurance plan, contact your dedicated Common Health care team today!

Get in touch with Common Health

Whether you’re looking to change doctors while on Medicare, need to schedule a telehealth appointment with your primary care provider, or something else entirely, Common Health is here to help.

We’re dedicated to helping people like you get the best care possible. That’s why we offer services like 24-hour care teams, house calls, and even telemedicine appointments for those who aren’t able to visit their doctor on their own. To put it simply, your health and comfort is our number one priority.

If you’re interested in learning how Common Health can transform your healthcare experience, contact us today. Leave us a message through the contact form on our website, or give us a call at (877) 465–4494 to speak with a member of our team directly.

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