If you have a Medicare Advantage plan, using providers that participate in your plan’s network can significantly affect your coverage and out-of-pocket costs.
Do not assume a provider is in-network simply because the office says, “We accept Medicare.” Accepting Medicare is not necessarily the same as participating in your specific Medicare Advantage plan.
When checking a provider, use the exact name of your health plan and, when possible, the specific plan.
You can verify participation by:
- Checking your health plan’s current provider directory.
- Calling the health plan using the number on your member ID card.
- Asking the provider’s office to verify participation with your specific plan.
For hospitals and procedures, you may also need to verify the facility and other providers involved in your care.
Provider networks can change, so it is a good idea to confirm participation before receiving non-emergency services, even if you have previously seen the provider.
If you are having trouble determining whether a doctor, hospital, or other healthcare provider participates in your plan, contact Regional Financial Security Agency. We can help you understand how to verify network participation before you receive care.