Enrollment & timing

Medicare Advantage Enrollees Can Switch Plans If Provider Directory Data Was Wrong

A rule effective for the 2026 plan year created a special enrollment period for beneficiaries who chose a Medicare Advantage plan based on inaccurate provider data in the federal plan finder.

By the Goodsurance editorial teamJuly 8, 2026

Provider directories in Medicare Advantage plans have long contained errors, listing doctors who left a network or stopped accepting new patients. A final rule published September 19, 2025, and effective for 2026 coverage, added a consumer protection designed to address this problem.

Beneficiaries who enrolled in a Medicare Advantage plan through the Medicare Plan Finder website and then discover that a preferred provider is not actually in the network may qualify for a special enrollment period to switch to a different plan or return to Original Medicare. To request a switch, beneficiaries can call 1-800-MEDICARE (1-800-633-4227).

Picked a 2026 Medicare Advantage plan based on a provider directory and your doctor is not in-network? There is a special enrollment period for that.

The same rule requires Medicare Advantage plans to submit updated provider directory data to CMS within 30 days of any change and to attest annually to its accuracy. CMS now displays plan provider directories directly on Medicare Plan Finder to make network comparisons easier before enrollment.

CMS acknowledged some data errors were expected in the first year of the new system. The Medicare Rights Center described accurate directory data as foundational to informed plan choice.

In plain words

When you pick a Medicare Advantage plan, you check to make sure your doctors are in the network. But those lists are not always correct. Starting in 2026, if you chose a plan using the Medicare Plan Finder website and later found your doctor is not in the network, you may be able to switch plans. This is called a special enrollment period. To use it, call 1-800-MEDICARE. CMS also told Medicare Advantage plans to update their doctor lists every 30 days and confirm each year that the lists are right.

Understand the basics first

Source: Federal Register
Read at the source →

More news

Other stories on what is moving in Medicare.

Enrollment & timing

KFF: 4.3 Million Medicare Beneficiaries Will Lose Their Plan at Year-End 2026, Including 1.2 Million on Standalone Drug Plans

A new KFF analysis finds that year-end plan terminations extend well beyond Medicare Advantage, catching 1.2 million people with standalone Part D drug plans who must also find new coverage before December 7.

October 28, 2026

Enrollment & timing

Plans Are Ending for 2027. Here Is What Medicare Advantage Members Need to Know Before December 7.

Beneficiaries whose plans will not return in 2027 have more time than the standard open enrollment deadline to find new coverage, but the window to ensure January 1 coverage closes at year-end.

October 24, 2026

Enrollment & timing

65 Medicare Advantage Plans for 2027 Have Hard Membership Caps That Could Close Before December 7

For the first time, CMS is letting Medicare Advantage plans set legally binding enrollment limits. Once a capped plan fills up mid-open enrollment, it closes to new applicants, and Medicare Plan Finder currently shows no warning.

October 22, 2026

Enrollment & timing

Medigap Access Barriers May Leave Many Medicare Advantage Enrollees With Fewer Real Choices During Open Enrollment

As the Medicare open enrollment period opened October 15, the Medicare Rights Center warned that most Medicare Advantage enrollees face health-based barriers to buying Medigap coverage, which could make switching to Traditional Medicare financially impractical even for those who want out.

October 16, 2026

Enrollment & timing

KFF: 120,000 People Waiting for Medicare Disability Coverage Used Medicaid as a Bridge. Work Requirements Starting January 2027 Could End That.

A new KFF analysis finds that more than 120,000 people who transition to Medicare through disability benefits each year had relied on Medicaid expansion while waiting out Medicare's two-year waiting period. A 2025 federal law applies work requirements to Medicaid expansion starting January 2027.

October 16, 2026

Enrollment & timing

Medicare Open Enrollment Opens as More Than 3 Million Advantage Members Face Mandatory Plan Changes

The 2027 Annual Enrollment Period began October 15, the third consecutive year in which millions of Medicare Advantage enrollees must find new coverage because their existing plans are not continuing.

October 15, 2026