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Do Doctors Accept Medicare Advantage? What Decides It in 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 31, 2026

No, not all doctors accept Medicare Advantage, and a doctor who takes one Medicare Advantage plan may not take another plan from a different insurer, or even a different plan from the same insurer. Medicare Advantage plans pay doctors through private contracts. Whether your doctor is covered depends on which plan you pick, what type of plan it is, and whether that doctor signed a contract with it for 2027.

That is different from Original Medicare, where you can see any doctor in the country who accepts Medicare. This guide explains how acceptance works for each plan type, uses our count of CMS 2027 plan files to show where PPOs are common and where they are scarce, and lists the steps to confirm your doctors before December 7, 2026.

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Do doctors accept Medicare Advantage 2027: 40% of standard plans are PPOs, 98 counties have no standard PPO, networks averaged 46% of county doctors in a KFF study, 11 PFFS plans filed for 2027

How Acceptance Works by Plan Type

Plan type Which doctors you can use If your doctor isn’t in the network
HMO Doctors in the plan’s network; you usually need a primary care doctor and referrals for specialists Not covered except emergencies, urgent care while away, and dialysis while temporarily away
HMO-POS The HMO network, plus some out-of-network services the plan lists Some services covered at a higher cost
PPO Network doctors at the lowest cost; out-of-network doctors also allowed Covered at a higher cost, but the doctor can still decline to see you
PFFS Any Medicare-approved doctor who agrees to the plan’s payment terms, often decided visit by visit A doctor can say no, even after treating you before

Source: Medicare.gov plan type descriptions; CMS plan type rules.

Emergency care is covered at any hospital in the United States under every Medicare Advantage plan, in network or not. The network rules above apply to planned, non-emergency care.

PPO share of standard 2027 Medicare Advantage plans: California 6%, Florida 23%, Arizona 26%, nationwide 40%, Utah 70%, Montana 74%, Minnesota 88%, North Dakota 100%

Our Analysis: Where PPOs Are Common and Where They're Rare

If keeping your current doctors matters most, a PPO gives you the most room, because it still pays something when a doctor is out of network. But PPOs are not spread evenly. We counted plan types in CMS’s 2027 plan files for standard (non-special-needs) individual plans.

Our analysis of CMS 2027 plan data

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Nationally, 1,389 of 3,516 standard 2027 plans (40%) are PPOs, 1,330 are HMOs and 785 are HMO-POS plans.

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California is mostly HMO: only 16 of 259 standard plans sold there (6%) are PPOs. In Florida the share is 23%.

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The Upper Midwest and Mountain West are mostly PPO: every standard plan sold in North Dakota, South Dakota, Vermont and Wyoming is a PPO, and 88% are in Minnesota.

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98 counties with standard plans have no standard PPO at all for 2027, and 44 counties have nothing but HMOs.

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Only 11 private fee-for-service plans are filed for 2027, from Humana, UnitedHealthcare and Arkansas Blue Medicare. They are sold in parts of 17 states, most widely in Arkansas, Virginia, Missouri and Illinois.

So the answer to “will my doctor take my plan?” depends partly on where you live. In a mostly-HMO state, your doctor has to be in network, full stop. In a mostly-PPO state, you often have a fallback.

How Big Are Medicare Advantage Networks?

The most detailed public study is older but still useful. KFF looked at 391 Medicare Advantage plans in 20 counties and found that the average network included 46% of the doctors in a county. More than one in three enrollees were in a narrow network, meaning fewer than 30% of local doctors. Psychiatrists were the hardest specialty to find in network, at 23% on average. KFF published those numbers in 2017 using 2015 data, so treat them as a sign of how much networks can vary, not a 2027 figure.

CMS sets minimum network standards under federal rule 42 CFR 422.116, which limits how far and how long members should have to travel for each type of provider. Meeting those standards doesn’t mean a particular doctor is included.

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Doctors and Hospitals Leaving Networks

Networks also change during the year. Becker’s Hospital Review keeps a running list of health systems ending Medicare Advantage contracts. Its 2026 list includes these changes, among others:

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Fairview Health Services (Minnesota): stopping scheduling for UnitedHealthcare Medicare Advantage patients for January 1, 2027.

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Ohio State University Wexner Medical Center and James Cancer Center: left Humana Medicare Advantage on October 1.

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NewYork-Presbyterian: UnitedHealthcare out of network August 1 unless a new agreement was reached.

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UNC Health: ended contracts with Humana and Health Care Service Corp. Medicare Advantage plans, among others, in January.

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Providence Clinical Network (15 California hospitals): left UnitedHealthcare in January.

A KFF Health News review found that CMS has offered special enrollment periods, often about three months long, to members in at least 13 states after major providers left their plans. Those are granted case by case: in Minnesota, CMS gave one to 14,000 Humana members but not to 46,000 Aetna and UnitedHealthcare members whose plans still had enough other providers. Specific cancer centers are covered in our guide to Mayo Clinic, MD Anderson and Moffitt.

Doctor leaving your plan in 2027?

If your doctor or hospital tells you it is leaving your plan, ask the plan in writing whether you qualify for continued care or a special enrollment period. Annual Enrollment, October 15 to December 7, 2026, is the simplest time to move to a plan that includes them.

How to Confirm Your Doctors Before You Enroll

1

Write down every doctor and facility you use, including specialists, the hospital you prefer, and your lab.

2

Search the plan’s 2027 provider directory, not the 2026 one. Directories update for the new year in the fall.

3

Call each doctor’s billing office. Ask: “Are you in network with [plan name and type] for 2027?” Use the full plan name, since an insurer’s HMO and PPO can have different networks.

4

Call the plan too, and get a reference number for the call.

5

Check that the doctor is taking new patients under that plan if you are new to the practice.

6

Have a backup. If your must-have doctor isn’t in any local plan, compare Original Medicare vs Medicare Advantage before you decide.

Check 2027 Plans That Include Your Doctors

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Do Doctors Accept Medicare Advantage? — Frequently Asked Questions

➤ Does every doctor who takes Medicare accept Medicare Advantage?

No. Accepting Original Medicare doesn’t mean a doctor is in network with any Medicare Advantage plan. Each plan has its own contracted network.

➤ Can I see an out-of-network doctor with a Medicare Advantage PPO?

Usually yes, at a higher cost, as long as the doctor agrees to see you. Emergencies are covered at any U.S. hospital under every plan.

➤ What share of 2027 Medicare Advantage plans are PPOs?

Our analysis of CMS 2027 plan files found that 40% of standard individual plans are PPOs. The share ranges from 6% in California to 100% in North Dakota, South Dakota, Vermont and Wyoming.

➤ Are there counties with no Medicare Advantage PPO in 2027?

Yes. In our count, 98 counties that have standard Medicare Advantage plans have no standard PPO, and 44 have only HMOs.

➤ What is a PFFS plan and do doctors accept it?

A private fee-for-service plan lets you see any Medicare-approved doctor who agrees to the plan’s terms, but the doctor can decide visit by visit. Only 11 PFFS plans are filed for 2027.

➤ Can my doctor leave my Medicare Advantage plan mid-year?

Yes. Doctors and hospitals can leave a network during the year. CMS sometimes grants a special enrollment period when a major provider leaves, but not always.

➤ How many doctors are in a typical Medicare Advantage network?

KFF’s study of 2015 data found networks included 46% of a county’s doctors on average, and more than a third of enrollees were in narrow networks.

➤ How do I know if my doctor is in network for 2027?

Check the plan’s 2027 provider directory, then call both the doctor’s office and the plan with the full plan name and type.

New to Medicare?

If you are new to Medicare, then you can enroll in a 2027 Medicare Advantage plan up to three months prior to your Medicare Part B effective date.

Call one of our licensed insurance agents to see what the best time frame is for you to enroll, based on your current situation. You can contact them at 1-855-454-9051 (TTY 711), Mon–Fri 8am–9pm EST.

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