Providence Medicare Advantage Plans Ending in 2027: Your Options

Are Providence’s individual Medicare Advantage plans ending?

Yes. Providence Health Plan’s individual Medicare Advantage plans are ending for 2027. This article is about individual Medicare coverage, not employer or retiree group Medicare plans. Check your written plan notice for your coverage end date and instructions.

Could Providence doctors also leave a plan’s network?

Yes, medical-group network changes are a separate issue. A Providence-affiliated group may not participate in every insurance carrier’s Medicare Advantage plans, and a group’s participation can vary by carrier, plan, county and year. Check each doctor and medical group in the exact 2027 plan you are considering. A Providence affiliation by itself does not confirm that a provider is in-network.

Which Providence-affiliated medical groups serve Southern California?

These Providence-affiliated medical groups and physician networks serve Southern California communities. The list can help you recognize your group, but it does not guarantee that a group or doctor participates in a particular 2027 plan. I can help you check how a specific plan handles your doctors.

Los Angeles County

• Facey Medical Group, including communities in the San Fernando and Santa Clarita valleys.
• Providence Medical Associates (including Axminster Medical Group).
• Saint John’s Physician Partners.
• Providence Affiliated Physicians, Los Angeles; Providence also lists Providence Medical Institute in its Los Angeles network resources.

Orange County

• Mission Heritage Medical Group and Providence Affiliated Physicians, Mission.
• St. Joseph Heritage Medical Group and Providence Affiliated Physicians, St. Joseph.
• St. Jude Heritage Medical Group and Providence Affiliated Physicians, St. Jude.

San Bernardino County and the High Desert

• St. Mary High Desert Medical Group.
• Providence Affiliated Physicians, St. Mary.

What are your Medicare options if your plan is ending?

If your current coverage is ending or your doctor’s network is changing, you may be able to choose another Medicare Advantage plan, or switch to Original Medicare with a Medicare Supplement (Medigap) policy and a separate Part D prescription drug plan. The right choice depends on the plans available where you live, your doctors and prescriptions, costs, and whether you qualify to buy a Supplement.

Option 1: Original Medicare with a Medicare Supplement and Part D

With Original Medicare, Medicare pays for covered hospital and medical services. You can generally see doctors and use hospitals that accept Medicare. A Medicare Supplement plan, also called Medigap, is separate insurance that can help pay some costs Original Medicare leaves for you to pay. A separate Part D plan helps cover prescription drugs.

This option can give you a broad choice of Medicare-participating providers, but it is three pieces of coverage to consider. A Supplement has its own monthly premium, and eligibility may depend on your situation and timing. If your Medicare Advantage plan is ending and you choose Original Medicare, you may have a guaranteed-issue right to buy certain Medigap policies without medical underwriting. The application window is limited, so review your plan’s notice and act promptly.

Option 2: Choose another Medicare Advantage plan

A Medicare Advantage plan, also called Medicare Part C, is another way to receive your Medicare benefits through a private plan. Many plans also include prescription drug coverage. This may feel more familiar if you currently have one plan card and a doctor network, but each plan has its own doctors, hospitals, costs and rules.

Before choosing, check your primary doctor, specialists, hospitals, prescriptions and pharmacies against the exact 2027 plan. A hospital being in a network does not automatically mean every doctor or medical group connected with it is in that network.

Know your enrollment dates

Annual Enrollment Period (AEP) is October 15 through December 7. During AEP, people with Medicare can review and change Medicare coverage for the coming year. Changes generally take effect January 1.

If your Medicare Advantage plan’s contract ends or is not renewed, you may have a Special Enrollment Period. The dates depend on how the plan ends. If the contract is terminated or Medicare and the plan agree to end it, the period generally begins one month before the contract ends and lasts through two full months afterward. If the contract is not renewed, the period generally runs from December 8 through the last day of February. Follow your written notice for the dates that apply to you. A provider-network change alone does not automatically give everyone a Special Enrollment Period; Medicare reviews some network-change situations individually.

If you are considering Original Medicare and a Supplement, ask about guaranteed-issue rights as soon as you receive a termination notice. In qualifying situations, you may apply as early as 60 days before your Medicare Advantage coverage ends and no later than 63 days after it ends. This right applies only if you switch to Original Medicare, not if you enroll in another Medicare Advantage plan. Keep the notice and confirm which Medigap policies you can buy.

Let’s review your notice and options together

I’ve been licensed since 2007 and help Southern California residents understand their Medicare choices. You don’t have to sort through the plan notice, provider networks and deadlines alone. I can review your notice, check the doctors and prescriptions that matter to you, and compare the Medicare options available in your area with you. There is no cost for my help.