This year at American Retirement Advisors, like all years during the annual election period, we faced a whirlwind of activity, and our phones were buzzing more than usual, but not for reasons you might expect... this year was a big year for doctors leaving networks. We've always been on our toes about this, especially during our annual enrollment season (Oct. 15 - Dec. 7). It's a critical part of what we do.
Let me share a story about a client we'll call Jane. Jane has been a long-time client since she first stepped into the world of Medicare several years ago. Every year when we send out our "request for information" emails, she immediately responds with her list of doctors and any new prescriptions. She's been quite fortunate with her Medicare Advantage plan all these years, as the one she picked has remained a standout plan for its consistency in benefits, co-pays, and network stability.
A Surprise Network Change
However, this year's review came with a hiccup. We discovered that Jane's primary care doctor wouldn't be in her plan's network for the following year. We quickly advised her to get in touch for an urgent plan review.
Jane was just as surprised as we were, and our early alert followed up with a letter from her doctor's office confirming the network change. She was amazed – how did we know before she did? And even more surprising to her, we had already researched every plan available in her area to consider helping her keep her doctor.
When Jane came in for her appointment, we didn't just have one, but several Medicare Advantage plans that included her doctor. But the cherry on top for Jane? We stumbled upon a new plan from a well-known company, packed with fantastic benefits that Jane could now enjoy along with staying with her favorite doctor. She was over the moon!
Jane's experience is a shining example of why being a client of American Retirement Advisors is more than selecting a plan; it's about having a team that's always one step ahead, ensuring your journey is 123Easy, every step of the way.
By David Edge
David Edge is a retirement lifestyle writer and contributor to the ARA monthly newsletter. His articles blend personal stories with practical insights on living well in retirement.
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Easy Eddie's Take
David's story about Jane happens more often than you might think. During Medicare Annual Open Enrollment (October 15 through December 7 each year), Medicare Advantage plans can change their provider networks, and sometimes your favorite doctor might not be covered anymore. Most people are surprised when they learn this, but it's actually pretty common.
Here's the good news: if you get that notice from your doctor's office saying they're leaving your plan's network, you have options. You can switch to a different Medicare Advantage plan during Open Enrollment, or you might consider switching to Original Medicare with a Medicare Supplement plan, which typically gives you more flexibility to see any doctor who accepts Medicare. The Centers for Medicare & Medicaid Services requires plans to send you notice of network changes, but as Jane discovered, sometimes your Medicare advisor knows first.
The key thing to remember is that you're not stuck. A little preparation during enrollment season can make a big difference in keeping the healthcare team you trust.