How to Keep Your Sharp Doctors When Your Medicare Plan Changes in 2027

Can you keep the same Sharp doctors?

Possibly. Some 2027 plans may include the Sharp Community primary care doctors and specialists you already see. However, finding one doctor does not mean that every specialist, clinic or hospital you use is also included.

You do not need to sort through the contracts or insurance terminology yourself. Give Franco the names of every doctor, specialist, clinic and hospital you want to keep. He can check them under the available plans and explain the choices in plain language.

Option one: another Medicare Advantage HMO with drug coverage

You may be able to move to another Medicare Advantage HMO that includes prescription coverage and the Sharp doctors you want to keep. Franco can check every current doctor and hospital, then compare the prescriptions, pharmacy and costs.

This keeps the decision focused on what matters to you: continuing your care and understanding what the new coverage will cost.

• Every primary care doctor and specialist you currently see
• The clinics and hospitals you want to continue using
• Your prescriptions and preferred pharmacy
• Your copays, coinsurance and maximum out-of-pocket limit

Why is a PPO not the simple answer for Sharp patients?

A PPO may sound flexible, but it does not guarantee access to every Sharp doctor or medical group. Sharp Rees-Stealy states that it generally does not accept Medicare Advantage PPO insurance, with a limited exception for certain established patients under one plan.

For someone whose priority is keeping particular Sharp doctors, another HMO or the Original Medicare route may be more dependable than assuming a PPO will work. Franco can check the available choices for you.

Option two: Original Medicare with Medicare Supplement coverage

The other route is Original Medicare with a Medicare Supplement plan. Sharp states that its affiliated doctors, hospitals and medical groups accept Original Medicare. A Medicare Supplement plan can help pay some of the costs that Original Medicare does not pay.

Medicare Supplement plans do not include prescription coverage. A person choosing this route generally needs to select a separate Medicare drug plan based on their prescriptions and preferred pharmacy.

• Confirm that each important doctor accepts Original Medicare.
• Verify Medicare Supplement eligibility before changing coverage.
• Compare a separate Medicare drug plan.
• Include all monthly premiums when comparing the two routes.

Could a plan termination create a Medicare Supplement right?

When a Medicare Advantage plan leaves Medicare, stops serving an area or is not renewed, returning to Original Medicare can create a limited Medicare Supplement guaranteed-issue right. The right may allow a person to apply for certain Medicare Supplement plans without being denied because of health conditions.

The application window is limited and follows a different timeline from the Special Enrollment Period for choosing another Medicare plan. Keep the Annual Notice of Change, termination notice, replacement notice and disenrollment confirmation because a Medicare Supplement company may request them.

What if you currently have Sharp Direct Advantage?

Sharp Direct Advantage combines Medicare medical and prescription coverage in one plan. If you receive a notice that your coverage is changing, being replaced or ending, do not assume that an automatic replacement keeps the same doctors, hospitals, prescriptions, costs or benefits.

Franco can compare another Medicare Advantage HMO that includes your doctors with Original Medicare, Medicare Supplement coverage and a separate Medicare drug plan.

How can Franco help you keep your Sharp doctors?

Franco can start with every Sharp doctor you currently see and the hospitals you want to keep, then check which available 2027 plans include them. He can also compare the Medicare Advantage HMO route with Original Medicare and Medicare Supplement coverage when both are available to you.

There is no separate cost to you for Franco's help. If you enroll through him and a policy is issued, the insurance carrier pays him. The review can include your doctors, prescriptions, pharmacy, costs, benefits and enrollment dates so you do not have to sort through the plan change alone.

• Bring your Annual Notice of Change and any termination or replacement letter.
• List every current doctor, specialist, clinic and hospital.
• Bring a current prescription list and preferred pharmacy.
• Keep copies of every plan notice and enrollment confirmation.

When do you need to make a decision?

The Medicare Annual Enrollment Period runs from October 15 through December 7. If a plan is not being renewed, the beneficiary also receives a Special Enrollment Period from December 8 through the last day of February of the following year.

Enroll by December 31 if replacement coverage needs to begin January 1. Do not wait until February to investigate a possible Medicare Supplement right because that application window follows separate rules.