Will I Be Able to Keep My Current Doctor When I Switch to Medicare?

ltcinsuranceshopper By ltcinsuranceshopper February 3, 2025


The transition from private or employer-based health insurance to Medicare marks an important milestone for those approaching or entering retirement. As people move into this new phase of life, many understandably worry about maintaining their continuity of care.

A common question among those considering Medicare is whether they can continue seeing their current doctors. This is especially crucial for individuals who have a strong relationship with their doctor and prefer not to switch to an unfamiliar provider.

If your doctor doesn’t accept Medicare, you likely won’t be able to continue seeing them after retirement. However, many doctors, particularly those who treat older patients (65 and up), do accept Medicare, so you’ll probably be able to keep your primary care physician.

With traditional Medicare (Parts A and B), you have the flexibility to see any doctor or healthcare provider who accepts Medicare, without needing referrals. This open network is one of the key benefits of Original Medicare.

Medicare Advantage, however, is a bit more complex. Since Medicare Advantage (Part C) includes both Part A and Part B, you can still see your current doctors if they accept Medicare. However, whether you can keep your dentist or optometrist depends on whether they’re in your plan’s network.

Medicare Advantage plans are provided by private insurers approved by Medicare and often have more limited networks compared to traditional Medicare. If you have a preferred dentist or specialist, be sure to check which networks they participate in before enrolling in a Medicare Advantage plan.

It’s crucial to review the plan details or contact the provider directly to understand any network restrictions. Some doctors may only accept Medicare under specific conditions or may not be accepting new Medicare patients.

Your choice of healthcare providers is determined by Medicare’s network, not your Medigap policy. Medigap is designed to help cover some of the out-of-pocket expenses associated with Medicare-covered services.

It’s a good idea to start researching doctors or specialists before you lose your current health insurance to avoid any surprises when you try to schedule an appointment after enrolling in Medicare. If you like your current doctor but they don’t accept Medicare, ask them for recommendations or referrals. They may know of other doctors who do accept Medicare or are in-network for your Medicare Advantage plan.

Original Medicare aims to provide coverage that works almost anywhere, while Medicare Advantage functions more like traditional health insurance, with more limited networks. This doesn’t make it worse—it simply means you may face similar network restrictions as people with employer-based insurance.

Not all Medicare Advantage plans have the same provider networks. Some offer more extensive access than others, and certain plans may require referrals to see specific specialists.

Like with other private health insurance plans, you might have to pay higher fees if you visit an out-of-network provider.

These restrictions don’t mean Medicare Advantage is inferior to Original Medicare—especially since certain specialists may not be covered under Parts A or B at all. For most retirees, a Medicare Advantage plan that is accepted by most local specialists offers a good health insurance solution.

Medicare might seem simple as you approach retirement age—it’s a free benefit, after all. However, while Original Medicare can save retirees money, it isn’t a complete health insurance solution. Having a solid Medicare strategy is essential for your future, particularly as your healthcare needs and costs evolve.

Need help? Call Brady Insurance Marketing: 801-347-2087. Our assistance is at no cost to you





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