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 →

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