Most doctors take Medicare, but not all, and some accept it only for certain types of care
The short answer is no — not every doctor in the United States accepts Medicare. About 95 percent of physicians do accept Medicare patients, but that leaves a meaningful number who do not. Even among doctors who do accept Medicare, some may limit the number of Medicare patients they see, or accept it only for specific services. Before you schedule an appointment, you need to verify that your doctor takes Medicare and understand what that means for your out-of-pocket costs.
The reason doctors can refuse Medicare is that Medicare is a government insurance program with set payment rates. A doctor who does not accept Medicare is choosing not to bill Medicare at all — they may see only private-pay patients, or they may work only with certain insurance companies. This is different from being "out of network," which means a doctor does take Medicare but you may pay more to see them.
Key Takeaways
- You can search for Medicare-accepting doctors using the official Medicare Provider Search tool on Medicare.gov, which shows whether each doctor accepts new Medicare patients.
- Some doctors accept Medicare but limit how many Medicare patients they see, so calling to confirm availability is necessary even after you find them in the search tool.
- Doctors who do not accept Medicare at all are allowed to do so, and you will pay the full bill yourself if you see them.
- If your current doctor does not take Medicare, you can ask whether they will make an exception for you or refer you to someone who does.
How to find doctors who accept Medicare
The fastest way is to use the Medicare Provider Search tool on Medicare.gov. Go to the site, enter your location and the type of doctor you need, and the search will show you doctors in your area who accept Medicare. The tool tells you whether each doctor is accepting new Medicare patients, which saves you the step of calling to ask.
You can also call your Medicare plan directly — whether you have Original Medicare or a Medicare Advantage plan — and ask for a list of in-network doctors in your area. If you have a Medicare Advantage plan, your plan's website usually has a searchable provider directory. If you have Original Medicare, you can call 1-800-MEDICARE and ask for doctors near you who accept Medicare assignment (meaning they accept Medicare's payment as full payment).
Your current doctor's office staff can also tell you whether the practice accepts Medicare. If you are switching from another insurance and want to stay with your doctor, ask them directly whether they will take Medicare once you enroll.
What "accepting Medicare" actually means
When a doctor accepts Medicare, it means they have agreed to bill Medicare for your care. But there are different levels of acceptance. Some doctors accept Medicare assignment, which means they accept Medicare's payment rate as the full amount they will charge you — you pay only your copay, coinsurance, or deductible. Other doctors may accept Medicare but not assignment, which means they can charge you more than Medicare allows.
A doctor who accepts Medicare assignment must accept Medicare's approved amount as payment in full. They cannot balance-bill you (charge you the difference between their fee and what Medicare pays). This is the arrangement you want, and it is the standard for most doctors who accept Medicare.
Some doctors also limit the number of Medicare patients they see. They may accept Medicare but not be taking new Medicare patients. This is legal, and it is why the Medicare Provider Search tool specifically tells you whether a doctor is accepting new patients.
Doctors who do not accept Medicare at all
A small number of doctors opt out of Medicare entirely. They do not bill Medicare at all and do not accept Medicare insurance. If you see a doctor who has opted out, you pay the full bill yourself, and Medicare will not reimburse any part of it — even if you have Original Medicare.
Some doctors who opt out of Medicare do so because they believe Medicare's payment rates are too low. Others may specialize in concierge medicine or direct primary care, where patients pay a monthly or annual fee for access to the doctor. A few opt out because they work only with patients who have private insurance.
Before you see a doctor who does not accept Medicare, ask them to give you a written notice of their opt-out status. Federal law requires them to do this, and it protects you by making clear that Medicare will not pay. If a doctor does not accept Medicare and does not give you written notice, you may be able to have Medicare pay part of the bill anyway.
What to do if your doctor does not accept Medicare
If your current doctor does not accept Medicare, you have a few options. First, ask the doctor directly whether they will make an exception for you as an established patient. Some doctors who do not generally accept Medicare will keep seeing patients they have been treating for years.
Second, ask for a referral to another doctor in the same practice or specialty who does accept Medicare. Your doctor's office staff often know which colleagues take Medicare and can point you in the right direction.
Third, use the Medicare Provider Search tool to find a new doctor in your specialty and area. You can also ask your primary care doctor for recommendations, even if they do not accept Medicare themselves.
Medicare Advantage vs. Original Medicare and doctor networks
If you have a Medicare Advantage plan, your plan has a specific network of doctors. You must use doctors in that network to get the lowest costs. The plan's website or member handbook lists all in-network doctors. If you see a doctor outside the network, you will pay more or the plan may not cover the visit at all.
If you have Original Medicare, you can see any doctor who accepts Medicare assignment, anywhere in the country. There is no network to check — as long as the doctor accepts Medicare, you can go there. This gives you more flexibility but also means you need to confirm that each doctor accepts Medicare before you schedule.
Questions to ask before your first appointment
Once you find a doctor who shows up in the Medicare search tool, call their office and confirm a few things. Ask whether they are currently accepting new Medicare patients (the search tool may not be updated in real time). Ask whether they accept Medicare assignment. Ask what your copay or coinsurance will be for the visit, and whether there are any additional fees.
If you have a Medicare Advantage plan, confirm that the doctor is in your plan's network. If you have Original Medicare, ask whether the doctor accepts Medicare assignment so you know you will not be balance-billed.
Frequently Asked Questions
Can a doctor refuse to see me because I have Medicare?
A doctor can choose not to accept Medicare patients in general, but once they have accepted you as a patient, they cannot refuse to treat you because you have Medicare. They also cannot charge you more because you have Medicare. If a doctor refuses to treat you solely because of your Medicare status after accepting you as a patient, you can file a complaint with your state medical board.
What is balance billing and can it happen to me?
Balance billing is when a doctor charges you the difference between their fee and what Medicare pays. If your doctor accepts Medicare assignment, balance billing is illegal — they must accept Medicare's payment as full payment. If your doctor does not accept Medicare assignment, they can balance-bill you. This is why confirming that your doctor accepts assignment is important.
If my doctor does not accept Medicare, can I still see them?
Yes, you can still see a doctor who does not accept Medicare, but you will pay the full bill yourself and Medicare will not reimburse you. The doctor must give you written notice that they do not accept Medicare before you receive care. Ask for this notice in writing so you understand the cost before your visit.
How often is the Medicare Provider Search tool updated?
Medicare updates the Provider Search tool regularly, but the information may lag by a few weeks. Always call the doctor's office directly to confirm they are accepting new Medicare patients before you schedule. Office staff can tell you when ready whether they have openings.
Do all specialists accept Medicare?
Most specialists accept Medicare, but not all. Specialists in high-demand areas or those who work only with private insurance may not. Use the Medicare Provider Search tool to find specialists in your area who accept Medicare, or ask your primary care doctor for a referral to a Medicare-accepting specialist.