With Original Medicare and a Supplement, you keep any doctor in the country who accepts Medicare, and about 98 percent of doctors do. With a Medicare Advantage plan, you keep your doctor only if that doctor is in the plan's network, and networks change every year. So the answer depends on which path you choose, and checking takes five minutes.
Original Medicare and a Supplement
No network, no referrals, no plan directory. If a doctor takes Medicare, they take you, and the Supplement pays its share automatically. This is the simplest answer to the doctor question and the reason many people who travel or who have a specialist they trust choose a Supplement.
The one thing to ask a doctor's office is whether they "accept assignment," meaning they accept Medicare's approved amount. Almost all do. A doctor who does not can bill up to 15 percent more, which Plan G covers and Plan N does not.
Medicare Advantage
Every Advantage plan has a directory of doctors, hospitals and specialists. If your doctor is in it, you are covered at the in-network rate. With an HMO, out-of-network care is usually not covered at all except in emergencies. With a PPO, you can go out of network but you pay more.
Two cautions. Directories are not always current, so I confirm directly with the doctor's office rather than trusting the list. And a doctor in the network this year can leave next year, which is one reason to review your plan every fall.
How I check
Give me the names of every doctor, hospital and specialist you want to keep, including the one you see once a year. I check each one against each plan before I recommend anything. If your doctors are all in a strong Advantage network, that opens up the low-premium option. If one of them is not, that usually decides it.
Prescriptions count too
The same check applies to your pharmacy and your drugs. A plan can cover your doctor and still leave your pharmacy out of network or put one of your prescriptions in an expensive tier.
Request a plan check, list your doctors and your prescriptions, and you get a yes or no for each plan before you sign anything.