Contact your Medicare Advantage plan as soon as you learn your doctor is leaving its network. Ask when the change takes effect, whether you can keep seeing the doctor during treatment, and who else in the network can provide your care.

Confirm the Change

Ask the plan for the doctor’s final in-network date. Federal notice rules differ by provider type:

  • Primary care or behavioral health provider (mental health or substance use care): the plan must give at least 45 calendar days’ written notice and try to call once, unless you opted out of calls about plan business. This applies if you are assigned to that primary care provider or received care from that primary care or behavioral health provider within the past three years.
  • Other providers: the plan must give at least 30 calendar days’ written notice if you are assigned to the provider, currently receiving care, or received care within the past three months.

When a provider’s contract ends for cause, the plan must make a good-faith effort to meet these notice dates. That timing exception does not apply to every departure. See 42 CFR 422.111(e).

Also call the doctor's office. A provider may participate at one location but not another, and directory information can lag.

Protect Ongoing Care

If you are pregnant, undergoing treatment, scheduled for surgery, or managing a complex condition, ask whether you can keep seeing the current doctor for a time, called continuity of care. Request a written coverage decision when appropriate and ask how records and existing authorizations will transfer.

If the plan cannot provide adequate access to medically necessary covered care, ask it to arrange appropriate care and explain how to appeal a coverage decision or file a complaint.

Find a Replacement

Request current in-network options and confirm participation directly with the new office. Check hospital affiliation, specialist access, appointment availability, and whether a new referral is needed.

A provider leaving does not automatically let every member change plans. Medicare may grant a Special Enrollment Period for a significant network change or exceptional circumstance, evaluated under applicable rules.

If surgery is already scheduled, give the plan the procedure date, clinician and facility and request a written answer about continuing care and your costs. Keep the departure notice and case number. If access remains unresolved, contact Medicare or your State Health Insurance Assistance Program (SHIP).

Medicare policy sources last checked: October 8, 2026.