What Medicare Network Does Original Medicare Use?

UNITED STATES—Hello Toni, I retired at 70 and my Medicare Part B will begin soon. I will no longer have employer health coverage, although COBRA is one option I could use. I also have health problems, which is why I stepped away from work. My cardiologist told me recently that heart surgery is the only thing likely to improve my condition.

I want to understand what Medicare network I should look for so I can be sure all of my doctors are included. I’m confused about which Medicare choice to make and I cannot afford to lose my cardiologist.

Should I join a Medicare supplement plan, choose a Medicare Advantage network plan, or remain on COBRA until it runs out in about 18 months? I read your recent article about insurers ending Medicare Advantage plans across the country, and I do not want to get stuck in that situation. Toni, I need your advice. Thanks, Kellie from Dallas.

Hello Kellie, since you are retired and will be on Medicare with Part B starting soon, I have good news for you. Original Medicare has no network of hospitals, doctors, or other medical providers. There is no network at all. You remain in control of your Medicare coverage.

You do not need to worry about finding an in-network provider because nearly all providers accept Medicare, and it is available nationwide. As your Medicare journey begins, your health concerns should be manageable because you will be in your Medicare Supplement/Medigap Open Enrollment Period. During that six-month window, you can enroll in a Medicare Supplement without answering any underwriting questions.

The ideal time to buy a Medicare Supplement is during the Medicare Supplement/Medigap Open Enrollment Period, which begins on the first day of the month in which you first enroll in Medicare Part B. That same special six-month period also applies to people turning 65. When I enrolled in Medicare Parts A and B and selected a Medicare Supplement Plan G along with a stand-alone Medicare Part D plan, my coverage began on May 1.

My advice is not to enroll in COBRA, because once you have been enrolled in Medicare for six months, you will no longer be in the Medicare Supplement/Medigap Open Enrollment Period and will have to answer health questions.

You also mentioned the ending of some Medicare Advantage plans. A termination letter was mailed explaining a special federal right to buy a Medicare Supplement without medical underwriting and to receive a guaranteed-issue Medigap policy, with a Special Enrollment Period running from December 8, 2026, through February 28, 2027. After that period, medical underwriting will be required to qualify.

Medicare’s Open Enrollment Period is meant for people who want to switch Medicare Advantage or Part D plans, or leave Original Medicare and enroll in a MAPD plan. So if you decide to move from Medicare with a Supplement to an MAPD plan, Oct. 15 to Dec. 7 is the time to make that change.

Remember: what you do not know about Medicare can hurt you.

Call the Toni Says Medicare hotline at (832) 519-8664 or email [email protected] for help with Medicare issues. Toni’s free Medicare First Steps guide at www.tonisays.com explains different situations during Medicare’s Open Enrollment Period.

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