Fair Square Medicare Wordmark

What to Do When Your Doctor Leaves Your Network

Cover image

By Daniel Petkevich

Jul 15, 2025

An overview of what to do when your doctor leaves your network for Medicare.

1 Verify it’s real

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

2 Ask about “continuity-of-care” rights

If you’re in mid-treatment (chemotherapy, pregnancy, post-op, etc.), the No Surprises Act lets you keep seeing that doctor for up to 90 days at in-network rates while you transition. Tell the plan you want to elect transitional care.

Centers for Medicare & Medicaid Services

3 Decide how to proceed

Option A: Stay with the doctor out-of-network. Expect higher cost-sharing—sometimes 100 % in an HMO. Option B: Pick a new in-network provider. Use the updated directory and get referrals transferred. Option C: Switch plans. If CMS rules the termination a “significant” network change, you get a Special Enrollment Period (SEP) to move to another Medicare Advantage plan—or drop MA, return to Original Medicare, and buy a Part D plan (and, in many cases, Medigap on a guaranteed-issue basis).

Centers for Medicare & Medicaid Services

4 Check timing

  • A CMS-granted SEP lasts two months after you’re notified.

  • Otherwise, your next chance to change plans is the Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31) or the annual fall window (Oct 15 – Dec 7).

5 Keep records

Save letters, EOBs, and any bills. If costs spike because the plan didn’t give proper notice or honor continuity-of-care, file an appeal and include your documentation.

Need help?

Call 888-376-2028 and our licensed Medicare advocates will:

  • Confirm your eligibility for a Special Enrollment Period,

  • Compare every local plan’s provider list, and

  • Walk you through the switch—no cost, no pressure.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Recommended Articles

Cover image

Medicare & Ozempic

Jul 20, 2023

Mental health stock photo

Does Medicare Cover Mental Health?

Oct 12, 2022

Pre-Existing condition stock image

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Mar 28, 2023

Close up top view of a woman showing a round-shaped Lipoma fatty tumor on an open palm stock photo

Does Medicare Cover Lipoma Removal?

Dec 8, 2022

Costco & Fair Square

Costco Pharmacy Partners with Fair Square

Jan 13, 2023

Senior woman smiling after vaccination stock photo

Does Medicare Cover Flu Shots?

Dec 9, 2022

older man suffering from stomach pain due to IBS stock photo

Does Medicare Cover Xiafaxan?

Jan 19, 2023

Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo

Does Medicare Cover Oxybutynin?

Dec 2, 2022

Senior woman having vision problems stock photo

Does Medicare Cover Macular Degeneration?

Nov 30, 2022

heart surgery stock image

How Much Does Open Heart Surgery Cost with Medicare?

Jan 27, 2023

Senior couple going over their finances in front of a computer stock image

How Much Does Medicare Part B Cost in 2025?

Dec 27, 2022

Rattlesnake biting on a hiker's boot stock image

Does Medicare Pay for Antivenom?

Dec 6, 2022

A doctor with a clipboard consults a female patient with cancer

Does Medicare Cover Inqovi?

Jan 11, 2023

Cover image

Seeing the Value in Fair Square

May 15, 2023

Cover image

10 Top Medicare Supplement (Medigap) Companies for 2025

Jul 14, 2025

Dripping medication stock photo

Does Medicare Cover Ketamine Infusion for Depression?

Nov 23, 2022

Doctor physician consulting with male patient in hospital exam room stock photo

Does Medicare Cover Penile Implant Surgery?

Dec 9, 2022

Medicare 2025 What you need to know in the new year stock image

How is Medicare Changing in 2025?

Dec 21, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Jacksonville

20 Questions to Ask Your Medicare Agent

2024 Fair Square Client Retention and Satisfaction Report

2024 Fair Square NPS Report

Are Medicare Advantage Plans Bad?

Can Doctors Choose Not to Accept Medicare?

Can I switch From Medicare Advantage to Medigap?

Can Medicare Help with the Cost of Tyrvaya?

Comparing All Medigap Plans | Chart Updated for 2025

Denied Coverage? What to Do When Your Carrier Says No

Do I Need to Renew My Medicare?

Do Medicare Supplement Plans Cover Dental and Vision?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover Abortion Services?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Cala Trio?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Compounded Medications?

Does Medicare Cover COVID Tests?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Exercise Physiology?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hoarding Cleanup?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Jakafi?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Ozempic?

Does Medicare Cover Qutenza?

Does Medicare Cover Stair Lifts?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Tymlos?

Does Medicare Cover Vitamins?

Does Medicare Pay for Allergy Shots?

Does Medicare Pay for Bunion Surgery?

Does Medicare pay for Opdivo?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Estimating Prescription Drug Costs

Everything About Your Medicare Card + Medicare Number

Explaining the Different Enrollment Periods for Medicare

Finding the Best Dental Plans for Seniors

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Does Medicare Cover Colonoscopies?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Cost?

How Much Does Medicare Part A Cost in 2025?

How Much Does Rexulti Cost with Medicare?

How Much Does Trelegy Cost with Medicare?

How Often Can I Change Medicare Plans?

How Your Employer Insurance and Medicare Work Together

Is Balloon Sinuplasty Covered by Medicare?

Is Displacement Affecting Your Medicare Coverage?

Is Emsella Covered by Medicare?

Is Gainswave Covered by Medicare?

Is HIFU Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Consulting Services

Medicare Explained

Medigap Plan N vs. Plan G — Which One Fits You in 2025?

Moving? Here’s What Happens to Your Medicare Coverage

Plan G vs. Plan N

Saving Money with Alternative Pharmacies & Discount Programs

What Are Medicare Part B Excess Charges?

What If I Don't Like My Plan?

What is a Medicare Beneficiary Ombudsman?

What You Need to Know About Creditable Coverage

When to Choose Medicare Advantage over Medicare Supplement

Why Is Medicare So Confusing?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

Fair Square Medicare

FSM symbol - 50