For most Medicare beneficiaries, the good news is that the majority of doctors, especially primary care physicians, do accept Medicare. However, it’s important to confirm your coverage before any appointment, particularly if you’re visiting a specialist.

You can verify by contacting the doctor’s office directly and providing your Medicare details. Alternatively, you can reach out to your Medicare plan provider for confirmation.

The quick answer is yes—about 93% of non-pediatric primary care doctors accept Medicare, nearly matching the 94% who accept private insurance. That said, acceptance can vary depending on the type of Medicare coverage you have and whether you’re an existing patient.

How to Find Doctors Who Accept Medicare

Medicare offers an online tool called Physician Compare that helps you locate doctors and facilities enrolled in Medicare. Visit the official Medicare website or call 1-800-MEDICARE for assistance.

If you have a Medicare Advantage plan, your insurer likely provides a doctor search tool on their website or you can call their customer service.

You can narrow your search by:

• Medical specialty or condition

• ZIP code or location

• Doctor’s last name

• Gender

• Hospital affiliation

Even after using these tools, it’s a good idea to call the provider’s office to confirm they accept Medicare and are accepting new patients.

Why Some Doctors Don’t Accept Medicare

Some doctors may decide to stop accepting Medicare due to lower reimbursement rates or administrative reasons. If this happens, you can either pay out-of-pocket or seek a different doctor who accepts Medicare.

Doctors who don’t accept Medicare assignment for all services are called non-participating providers. They are enrolled in Medicare but may choose whether to accept Medicare’s approved payment on a case-by-case basis.

What to Do If Your Doctor Doesn’t Accept Medicare

Non-participating doctors can charge up to 15% more than Medicare’s approved rate, called the limiting charge. Certain states limit this extra charge to 5%.

This additional charge is in addition to the usual 20% coinsurance that Medicare requires.

Doctors may ask for payment at your visit or bill you afterward. Be sure to ask about payment policies before your appointment so you know what to expect.

If you pay out-of-pocket, you generally have one year to file a claim with Medicare to get reimbursed.

Bottom Line

Most doctors accept Medicare, but it’s always wise to verify. If your doctor stops accepting Medicare, ask how this impacts your coverage and what your options are to avoid unexpected costs.