Networks & Providers
Provider Directory
Quick answer
A provider directory is the plan's searchable list of in-network doctors, hospitals, and other providers. Use it to confirm your care team is covered.
Plain-English definition
Directories are updated regularly but can be out of date; call to confirm.
Why it matters
Verifying your doctors upfront prevents surprise bills.
A simple example
You look up your dermatologist in the plan's online directory and call the office to confirm.
Common mistakes & misconceptions
Related terms
Network
A network is the group of doctors, hospitals, and other providers that have contracted with a Medicare Advantage or Part D plan to deliver care and drugs at agreed rates.
In-Network
An in-network provider has a contract with your plan to deliver care at negotiated rates. You pay the plan's lowest cost-sharing when you stay in-network.
HMO
A Medicare Advantage HMO is a plan that uses a specific network of doctors and hospitals. You choose a primary care provider (PCP) and usually need a referral to see specialists.
PPO
A Medicare Advantage PPO lets you see providers in or out of the network, usually without a referral. Out-of-network care costs more and has its own MOOP.
Frequently asked questions
Are directories accurate?+
Mostly — always confirm by phone.
Sources & references
📚 Where this information comes from
- Medicare.gov — official U.S. government site for people with Medicare ↗Primary source for benefits, enrollment periods, and plan comparison.
- CMS.gov — Centers for Medicare & Medicaid Services ↗Federal rulemaking, program updates, and official guidance.
- Social Security Administration — Medicare enrollment & premiums ↗Enrollment, premium withholding, and IRMAA determinations.
When you're ready, compare plans on your own terms
See Medicare Advantage plans from the insurance companies we represent, or walk the course with a licensed agent whenever you'd like a second set of eyes.
We help compare Medicare Advantage plans from the insurance companies we represent, and we don't offer every plan available in your area.
Medicare Caddies is an independent insurance agency. We are not affiliated with, endorsed by, or connected to the U.S. government, the federal Medicare program, or the Centers for Medicare & Medicaid Services (CMS). We help compare Medicare Advantage plans from the insurance companies we represent, and we don't offer every plan available in your area.