How to Verify a Medicare Advantage Provider Network
Short answer
Medicare Advantage networks can change. Verify the exact provider, facility, location and plan using current plan information before relying on network status for non-emergency care.
Coverage And Action
Check the plan’s current directory and, for important care, confirm directly with both the provider and plan. Preserve screenshots or call references when network status is material to an enrollment or treatment decision.
Not Automatic
A provider’s participation in one plan, medical group or office location does not establish participation in every product from the same carrier. Historical directory information is not a guarantee of future participation.
Practical Example
A physician may be in-network at one office or under one medical group but not for the exact Medicare Advantage product being considered.
Questions to verify
- Did I verify the exact plan and location?
- When was network status confirmed?
- Is continuity care available if the network changes?