One of the most common concerns people have when considering Medicare Advantage plans is
“Can I keep my current doctor?”
Keeping Your Trusted Doctor: What You Need to Know
This is especially true in places like Prescott, AZ, where having a long-standing relationship with a local physician is a vital part of your health and peace of mind. The answer to this question isn’t always straightforward but with the help of a local Medicare broker, you can get the clarity you need.
At Ed McMahan Medicare Insurance, we specialize in helping Arizona residents choose the Medicare Advantage plan that not only offers great benefits but also keeps them connected to the doctors and specialists they trust.
Let’s break down how Medicare Advantage plans work when it comes to provider networks and how you can make sure your doctor stays part of your healthcare journey.
What Is a Medicare Advantage Plan?
Medicare Advantage (Part C) is an alternative to Original Medicare, offered by private insurance companies approved by Medicare. These plans bundle Part A (hospital) and Part B (medical) and often include Part D (prescription drug coverage) as well as extra benefits like
- Vision and dental care
- Hearing aids
- Gym memberships
- Transportation to appointments
But unlike Original Medicare, Medicare Advantage plans have provider networks—and that’s where the doctor issue comes in.
Will I Be Able to See My Current Doctor?
The answer is: It depends on the plan.
Each Medicare Advantage plan has a specific network of doctors, hospitals, and specialists. If your current doctor is in-network, you can continue seeing them—sometimes even without a referral. If not, your ability to stay with them depends on the type of Medicare Advantage plan you choose.
Types of Medicare Advantage Plans and Provider Access
Here’s how different types of Medicare Advantage plans work when it comes to seeing your preferred doctor:
HMO (Health Maintenance Organization)
Strict network rule
Requires referrals for specialists
You must use in-network providers (except in emergencies)
If your doctor is not in the plan’s network, you may have to switch or pay out-of-pocket.
PPO (Preferred Provider Organization)
Greater flexibility
You can see out-of-network providers, but at a higher cost
No referral required for specialists
PPO plans are a better option if keeping your doctor is a top priority and they’re not in-network.
PFFS (Private Fee-for-Service)
No formal network, but providers must agree to the plan’s terms and conditions each time they provide care
More provider choice, but less predictability
These plans can sometimes allow you to keep your doctor if they agree to accept the plan.
How to Check If Your Doctor Accepts the Plan
Before enrolling in a Medicare Advantage plan, it’s critical to verify:
Is my doctor in the network?
Are my nearby hospitals included?
What specialists can I access?
This is where working with a local Medicare broker like Ed McMahan becomes incredibly valuable. He does the research for you—calling offices, checking plan directories, and ensuring you get accurate answers.
Why Local Knowledge Matters in Prescott, AZ
Healthcare is local. Prescott and surrounding areas have a unique network of doctors, hospitals, and specialists. A broker familiar with the area knows which plans typically include:
YRMC (Yavapai Regional Medical Center)
Local cardiologists, orthopedic doctors, and family physicians
Well-known clinics and urgent care facilities
At Ed McMahan Medicare Insurance, we know which plans your provider accepts, and we can match you with the right plan accordingly.
Office Address: 3623 Crossings Dr, Ste 277, Prescott, AZ 86305
📞 Phone: (928) 379-0172
📧 Email: edmcmahan2020@gmail.com
❓ Frequently Asked Questions (FAQs)
Can Doctors Drop Out of a Network?
Yes, even if your doctor accepts your Medicare Advantage plan today, they can leave the network in the future. That’s why it’s important to review your plan every year during Medicare Open Enrollment (October 15–December 7).
A trusted broker like Ed provides yearly plan reviews so that you’re never caught off guard.
What If I Can’t Keep My Doctor?
If your current doctor doesn’t accept any Medicare Advantage plan you like, you have a few choices:
Switch to a plan that includes your doctor
Choose a new doctor within the plan’s network
Stick with Original Medicare + Medigap, which offers broader provider access
Your choice depends on your health needs, budget, and how much you value keeping your doctor. Ed can walk you through all the pros and cons so you can make a confident decision.
Can I keep my doctor if I switch to Medicare Advantage in Prescott?
Only if the doctor is in your plan’s network—or you choose a PPO or PFFS plan that allows out-of-network providers.
How can I find out if my doctor is in-network?
You can ask the doctor directly or work with a local broker like Ed McMahan who will verify it for you.
What happens if my doctor leaves my Medicare Advantage plan’s network?
You may need to change doctors or switch plans during the next enrollment period.
Which Medicare Advantage plan gives me the most freedom with providers?
PPO plans generally offer the most flexibility if you want to see out-of-network doctors.
Is it better to work with a local broker?
Yes. A local broker like Ed McMahan knows the Prescott healthcare system, which doctors accept which plans, and how to get you the best local coverage.