About 4,500 patients of InterMed, a Portland practice, are about to find out that their doctor will be out of network, according to InterMed. Martin’s Point Health Care says InterMed will stop accepting its Generations Advantage Medicare Advantage plans on January 1, 2027. Martin’s Point says InterMed has told it that it is unwilling to negotiate any agreement for 2027.
The count comes from InterMed. The plan side says coverage today has not changed. That leaves a narrow window of about seven weeks, between now and the December 7 close of Medicare’s yearly enrollment period, for members to decide whether to follow the doctor or follow the plan.
Which members have a real decision to make
Not everyone on a Generations Advantage plan is affected. The change matters to members whose primary care doctor, or whose other care, is with InterMed, including the practice’s South Portland, Portland and Yarmouth locations. Martin’s Point says its own health care centers in Portland, Scarborough, Brunswick and Biddeford have providers accepting new Generations Advantage patients.
The plan’s wider network is large, with more than 15,000 providers across major health systems in Maine and New Hampshire. Members can use any network provider, not only Martin’s Point clinics, according to the FAQ. The plan says in-network providers carry the best coverage and the lowest out-of-pocket costs.
Anyone who sees an InterMed doctor and is on a Generations Advantage plan faces a choice with two shapes. One is to stay in the plan and find a new in-network primary care doctor. The other is to leave the plan for a different 2027 plan that still includes InterMed, if any plan in the area does.
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InterMed and Martin’s Point tell it differently
InterMed president Phyllidia Ku-Ruth said in a written statement that the practice had raised concerns with Martin’s Point in recent years about the structure of the insurance agreement, which makes it harder to deliver high-quality care. She added that the decision was not made lightly and that notice was being given more than eight months in advance, according to Maine Public.
Martin’s Point spokesperson Steve Amendo called the announcement unexpected and said communications went to impacted members without meaningful prior discussion with the plan. He said Martin’s Point will keep offering Medicare Advantage in Maine next year. In its own member FAQ, the plan says InterMed made the decision to end its participation.
The one plan type with a different rule
The FAQ draws one distinction that changes the math. Members of Generations Advantage Select, a local PPO, do not need an in-network primary care doctor. For 2027, the plan says, they can keep their InterMed doctor and pay out-of-network copays or cost shares.
Members of HMO and HMO-POS plans are different. The FAQ says those members must have an in-network primary care provider on file. For them, staying with InterMed after January 1 is not a workable option inside the plan. The out-of-network price for Select members has not been spelled out on the page, so the plan’s evidence of coverage is where the actual copay shows.
What moving a primary care relationship involves
Martin’s Point says members can choose a new primary care doctor whenever they are ready, and that if care moves before January 1 its team can help. Members do not have to notify InterMed, though the plan recommends a courtesy message to the current doctor. The change can be made through the member portal or by calling Member Services at 1-866-544-7504.
Records are the piece people tend to put off. The FAQ says the new doctor’s office can request records from InterMed, usually with a release form. The new doctor can also review current medications and send updated prescriptions to the member’s pharmacy, and can coordinate mail-order or specialty refills.
The plan’s directory lists an accepting-new-patients icon, and Martin’s Point advises calling the office to confirm. Medicare’s Plan Finder shows which other 2027 plans are sold in an area, and the doctor’s office can say which of them it accepts. A call to the office is worth making before committing, because a doctor listed as in network may still not be taking anyone new.
What the December 7 date does and does not close
Medicare.gov says the Open Enrollment Period runs October 15 to December 7, with a new plan starting January 1. A second window, January 1 to March 31, lets people already in a Medicare Advantage plan switch plans or return to Original Medicare, with coverage starting the month after the request.
That second window gives some cushion for members who stay put and then find the new doctor is a poor fit. It does not help a member who wants a plan that includes a particular specialist from day one. For that member, the comparison has to happen before December 7.
Keeping the InterMed doctor or keeping the Martin’s Point plan?
For a Generations Advantage member with an InterMed doctor, a wrong guess shows up on January 1: a first visit billed at out-of-network rates, or a plan switched in March to chase a doctor who was never in the new plan.
The 2027 Medicare Open Enrollment Decision Kit has a cost calculator spreadsheet that compares plans on cost, drugs and doctors, so the doctor question and the price question sit in one table. It also includes a provider call script for asking an office which 2027 plans it takes, and the Open Enrollment calendar for the December 7 date.
Part 2 is a drug and doctor coverage check, built for exactly this choice between a person and a plan.
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
