Picking a Medicare Advantage Plan by December 7? CMS Found 44% of Directory Listings Wrong. Your Protection Starts in 2028.

If you’re shopping Medicare Advantage plans before December 7, the provider directory is the thing you trust most and should trust least. Federal reviewers checked those directories and found an error in 44% of the location listings.

Congress already passed a fix. It makes the plan eat the cost when its own directory sends you to the wrong doctor. It starts January 1, 2028.

The plan you pick this fall runs through 2027.

What CMS found

Medicare Advantage plans are private plans that replace Original Medicare, and most of them run on networks. The directory is how you find out who’s in.

From June 2022 to June 2024, CMS checked directories at 142 Medicare Advantage organizations. Reviewers called provider offices to confirm the listings. Of 18,852 locations, 44.29% had at least one problem. The list in CMS’s own words: the provider “did not see patients at the location listed,” the phone number or address was wrong, or the provider “did not accept the plan at the location.”

CMS didn’t publish a report on those reviews. The number surfaced in a proposed rule on October 20.

That rule implements the REAL Health Providers Act, passed in the spending law signed February 3, 2026. Starting in 2028, if a directory listed your doctor as in-network on the day you booked, your cost sharing is capped at the in-network rate and the plan refunds the difference. If records are missing, CMS says the plan has to rule in your favor unless it can prove the doctor was never in the network.

Good rule. Plans just get two more years before it bites.

What it costs you in 2027

If your plan is an HMO, Medicare.gov’s own HMO page says it flat out: “If you get health care outside the plan’s network, you may have to pay the full cost.”

So picture the 2027 version of CMS’s own example. The directory lists a cardiologist as in-network. You book, you go, the claim comes back out-of-network. In an HMO, that can be the whole bill. In 2028, it’s your in-network copay.

Same doctor, same mistake. One year apart.

What to do before December 7

Call every doctor you can’t lose. Don’t ask whether they take the insurance company. Ask whether they’re in network for the exact plan name you’re looking at, for 2027. Write down who you talked to and the date.

Screenshot the directory listing with the date showing. It won’t trigger the 2028 protection, but it’s evidence if you file a grievance or appeal.

Weight the network over the premium. A $0 plan whose specialists don’t answer the phone is not free.

If you’re already in a plan and the network falls apart in January, use the Medicare Advantage Open Enrollment Period, January 1 to March 31, to switch plans or go back to Original Medicare.

Our Medicare guide covers the plan types, and our open enrollment guide has the calendar. For 2027 premiums by state, see what Medicare Advantage costs next year.

The detail

The same proposed rule cuts the generic drug copay from $1 to $0 for the lowest-income people on both Medicare and Medicaid in 2028 (CMS says that copay is $1.60 in 2026), and puts new reporting rules on drug-plan middlemen. Comments are open until December 15, 2026, under CMS-4214-P. If a wrong directory has already cost you money, that docket is the place to say so.

How Candid Yak makes money. Some of the products we write about pay us if you apply or sign up through our links. That never changes our verdict, our rankings, or the numbers in this article. We call a bad deal a bad deal whether it pays us or not. Some brands shown in our comparison tools are placeholder examples while we finalize partner agreements, and we label them as such.