For many Medicare beneficiaries in New Hampshire, one of the most important parts of choosing a health plan is understanding which doctors, specialists, and hospitals are included in the network. As we approach 2026, several shifts in provider networks are expected, making it especially important for seniors to stay informed during Medicare plan reviews.

How Medicare Networks Work in New Hampshire

Most Medicare Advantage (Part C) plans in New Hampshire use network-based coverage. This means your access to doctors and hospitals—and the prices you pay for care—depend on the plan’s contracted providers. The two most common types of networks are:

HMO Plans: These require you to use in-network providers for almost all services. Referrals are often needed for specialist visits.

PPO Plans: These offer more flexibility, allowing beneficiaries to see both in-network and out-of-network providers, though out-of-network care typically costs more.

Because networks vary between carriers, and even between plans within the same carrier, it’s important to review them annually to ensure your preferred doctors and hospitals are still included.

New Hampshire’s Major Health Systems

Medicare Advantage networks in New Hampshire commonly include a mix of local and regional health systems such as:

- Catholic Medical Center (CMC)
- Elliot Health System
- Dartmouth Health
- Concord Hospital Health System
- Southern NH Health
- Frisbie Memorial Hospital and Portsmouth Regional Hospital
- Wentworth-Douglass Hospital

Availability varies by plan, and some networks are more limited depending on your county or ZIP code. It’s always best to verify with a current provider directory during Medicare Open Enrollment.

What’s Changing in 2026

While full 2026 network maps won’t be officially released until next fall, several statewide trends are already expected to influence networks:

- Refinements to Medicare Advantage network contracts: Many New Hampshire carriers are expected to renegotiate provider participation, which may shift which hospitals or physician groups are considered in-network next year.

- More focus on coordinated care: Plans may continue expanding partnerships with integrated systems—such as Dartmouth Health and Southern NH Health—to streamline referrals, telehealth access, and chronic condition management.

- Potential narrowing or restructuring of some networks: As carriers adjust costs and quality measures, certain plans may change their service areas or limit access to out-of-state providers, which affects beneficiaries in border towns who rely on Massachusetts or Maine specialists.

- Updates to star ratings and quality-based networks: Medicare’s evolving quality rules may influence which provider groups stay contracted for 2026, particularly for plans emphasizing value-based care.

Why Annual Network Reviews Matter

Even small shifts in network contracts can impact your care. A doctor you’ve seen for years might move out-of-network, or a preferred hospital system may no longer participate in certain plans. Reviewing your coverage annually ensures you’re not surprised by unexpected changes in January.

If you rely on specific specialists, travel frequently, or are managing a chronic condition, a plan’s network can make a big difference in both access and cost. Taking time to compare options—especially with the 2026 updates on the horizon—can help you stay confident in your healthcare coverage.

As the new plan year approaches, staying informed about network changes will help you make the best Medicare decision for your needs here in New Hampshire. If you’d like help reviewing your options, working with a local Medicare advisor can make the process simple and stress-free.