Follow this before you compare plans
Write the doctor’s name and the office address.
Ask the office: “Does this doctor accept Original Medicare patients?”
Yes
You can generally keep this doctor with Original Medicare. A Supplement does not add or remove the doctor. Ask whether excess charges apply.
Only some Advantage plans
Write the plan names, not only the company. You can keep this doctor only on those plans, at that address, this year.
No
Medicare will not pay this doctor. Ask who they recommend instead, then check that doctor the same way.
Ask which hospital you would use, which medical group the doctor is in, and whether your specialists are in that group. Ask if you need a referral.
If they name a medical group
In Los Angeles County, these are the usual patterns. A group can be delegated on one Medicare Advantage plan and not on another. The contract decides, not the logo. This is not a list of who is in a plan.
- Group handles referralsOn many Los Angeles County HMO contracts, the group handles referrals and prior approval. Another plan can leave that work with the plan.Examples: Optum, HealthCare Partners, Regal, Lakeside, Heritage, AppleCare, Allied Pacific, Prospect, Greater Covina, Axminster, Seoul, Preferred IPA, HealthCare LA, Global Care, and Angeles IPA.
- Only some jobs moveThe plan keeps some jobs and gives others to the group. Which ones depend on the plan. Ask who approves a referral on your card.Examples: AltaMed, Facey, and UCLA.
- Hospital medical groupThese doctors work for a hospital system. When you need a referral or an approval, you usually ask the Medicare Advantage plan, not the medical group.Examples: Cedars-Sinai, USC Care, Keck Medicine, Providence, PIH Health Physicians, MemorialCare, Torrance Memorial, and City of Hope.
- Plan and doctors togetherThe health plan and the doctors are one system. Another Medicare Advantage plan does not assign this group.Examples: Kaiser Permanente.
Check those same names on Medicare.gov before you decide.
Original Medicare
You can generally keep a doctor who accepts Original Medicare and is taking patients. Ask whether excess charges apply. A small number of doctors opt out of Medicare. If the office says they do not take Medicare, this doctor is not an option under Original Medicare.
Medicare Advantage
You can keep the doctor only if that doctor, at that address, is in that plan’s network this year. “We take Medicare” usually means Original Medicare. It does not mean every Advantage plan.
A Medicare Supplement
A Supplement does not create a network and it does not add doctors. It helps pay costs after Original Medicare. The office still has to accept Original Medicare.
Why the plan count is not the first step
In 2027, CMS lists 124 Medicare Advantage plans in Los Angeles County. Most are HMOs. Only 6 are PPOs. Five of those plans do not include drug coverage. The count does not tell you whether your doctor is included. You need to ask the doctor's office questions about the plans they accept.
Common questions
- The office said they take Medicare. Does that mean every Advantage plan?
- No. “We take Medicare” usually means Original Medicare. Ask which plan names they take at that address this year, then check those names on Medicare.gov.
- My specialist is in a different medical group. Does that matter?
- It can. Many Los Angeles County HMO plans also use a medical group. A specialist can be on the plan and still be outside your group. Ask the office whether that specialist is in the group, and whether you need a referral.
My Medicare Checkup
Use the checkup to list the doctors you want to keep, then ask the office.
Start My Medicare CheckupYou will get a summary of the questions to verify. You can also talk it through with Alan.
For the other pages on this topic, open the Keeping your doctors guide.