You’re partway through a course of physical therapy, or a few months out from surgery and still seeing your surgeon for follow-up, and a letter arrives: your doctor is leaving your Medicare Advantage plan’s network. Whether it’s your primary care doctor or a specialist you’ve seen for years, it’s easy to assume that means switching providers immediately, mid-treatment, whether you’re ready or not.
That assumption is often wrong. Most Medicare Advantage members don’t know they may have the right to keep seeing that same doctor, at in-network cost, until their active treatment is finished, without any disruption to their Medicare coverage.
According to Medicare.gov, Medicare Advantage insurance companies negotiate contracts with doctors, specialists, and hospitals every year, and those contracts can end at any time, not just at renewal. Each health insurance company sets its own network, so a doctor can leave one plan while staying in-network with another.
A 2026 Johns Hopkins Bloomberg School of Public Health study found that roughly 1 in 10 Medicare Advantage members, about 2.9 million people, had to deal with a network change tied to 2026 coverage. A provider leaving your plan’s network mid-year is disruptive, but it isn’t rare, and your plan can’t spring it on you without warning. Learn more about why Medicare Advantage networks change every year.
When a doctor’s contract with your Medicare Advantage plan ends, your plan must give you written notice before the change takes effect, generally at least 30 days in advance. That notice is your cue to act, not just a formality to file away.
If you’re in the middle of active treatment with that doctor – think post-surgery follow-up care or an ongoing course of physical therapy – you can ask your plan in writing to continue seeing that doctor at your normal in-network cost for a transition period. This is often called continuity of care, and transition periods of up to 90 days are common while your care is safely handed off or completed.
Agent tip:
“Don’t wait for the transition period to be offered. Call your plan and ask specifically for a continuity-of-care or transition-of-care request in writing, and reference the treatment you’re in the middle of. Plans don’t always volunteer this option upfront.”
This protection isn’t unlimited. Routine annual visits, like your yearly wellness exam, generally don’t qualify. It’s designed for treatment already underway, not for care you haven’t started yet.
Start with your plan’s provider directory on Medicare.gov or your plan’s website. Plans must now keep this information updated and attest to its accuracy. Directories can still lag behind real-world changes, though, so if you get a network change notice or you’re unsure, take two more steps. Call your plan’s member services number (on the back of your card) to confirm your doctor’s status under your specific plan, and ask how to request continuity of care in writing if they’re leaving. Then check with your doctor’s office, which often knows about contract changes early.
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Local, licensed insurance agents with 25+ years of combined experienceContinuity of care protections are generally meant for situations like:
What usually doesn’t qualify: a routine annual physical, a first-time visit to a new specialist, or preventive screenings you haven’t started yet. If you’re not sure whether your situation qualifies, call your plan and ask directly, rather than assume.
Continuity of care buys you time with your current doctor, but it doesn’t change your plan itself. Normally, once you’re enrolled in a Medicare Advantage plan, you’re locked in until the next enrollment period.
There’s an exception. If the Centers for Medicare & Medicaid Services (CMS) determines that a plan’s provider losses amount to a “significant network” change, affected members can qualify for a Special Enrollment Period, a window that lets you switch plans or return to Original Medicare outside the usual enrollment calendar.
Original Medicare doesn’t use a provider network, so you can see any doctor or hospital that accepts Medicare. CMS determines whether a particular network loss qualifies on a case-by-case basis, so it’s worth asking your plan or a licensed agent whether your situation counts.
Your plan type also shapes how much a network change affects you day-to-day. Medicare Advantage PPO plans typically allow you to see out-of-network providers at a higher cost, while HMO plans generally don’t cover out-of-network care except in emergencies. Once any continuity-of-care transition period ends, a new or different plan may apply its own prior authorization rules to your ongoing treatment, so confirm what’s required before your transition period runs out.
A network change letter doesn’t have to mean scrambling for a new doctor while you’re still mid-treatment. If you’re in the middle of active health care, you may have the right to finish it out with your current doctor at in-network cost, but you generally have to ask for it in writing, and the sooner, the better.
Have questions about a network change notice you’ve received? Call (623) 223-8884 to speak with a local, licensed agent at no cost.
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Often, yes, if you’re in active treatment. You can request a continuity of care transition period in writing, which commonly allows up to 90 days of continued in-network cost coverage while your care is completed or safely transferred.
Plans generally must give written notice at least 30 days before the change takes effect, though the exact timing can vary by provider type and plan.
Active, ongoing treatment typically qualifies, such as post-surgery follow-up care or a course of physical therapy. The protection is meant for care already underway.
No. Routine or preventive visits, like an annual wellness exam, generally don’t qualify. This protection is intended for active courses of treatment, not routine check-ins.
Call your doctor’s office to confirm the change, then call your plan to request a continuity-of-care extension in writing if you’re mid-treatment. Keep copies of everything you send and receive.
Read more by Renee van Staveren
Since 2009, I've been writing about complicated, technical issues, with the goal of making topics like Medicare and healthcare easier to understand. I've been writing about Medicare since 2021 and healthcare since 2019. I am an AmeriCorps alumni. I enjoy gardening, reading, and DIYing.
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