Fair Square Medicare Wordmark

Can Doctors Choose Not to Accept Medicare?

Male doctor with his arms crossed stock image
By Daniel Petkevich
Dec 8, 2022

Read this before going to the doctor

Over 90% of doctors nationwide accept Medicare, to match with the 96% of age-eligible Americans receiving Medicare benefits. However, that leaves over 9,000 physicians who have decided to opt out of Medicare,

according to KFF

. This number may continue to grow in years to come, which could mean an expensive visit for you. Let's talk through which doctors are choosing not to accept Medicare and what you can do to save money.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

How do doctors become certified to accept Medicare patients?

Doctors must enroll in Medicare's program to receive reimbursement for services they provide to Medicare beneficiaries. To do this, doctors must apply with a signed agreement stating that they accept the conditions and fees set by Medicare. Once certified, most doctors are obligated to accept all patients with Medicare insurance coverage.

Why do some doctors choose not to accept Medicare patients?

There are several reasons why some doctors choose not to accept Medicare patients. One of the most common reasons is that they do not feel that the reimbursements provided by Medicare cover the costs associated with providing care for these patients. Additionally, some doctors may have concerns about the paperwork or bureaucracy that comes along with treating Medicare patients. Other doctors may simply be overwhelmed with the number of patients they already have and don’t want to take on additional Medicare beneficiaries.
Some of the highest opt-out rates are among psychiatrists. According to KFF, over 40% of the Medicare opt-outs are from the field of psychiatry. This could prove challenging if you are among the growing number of seniors seeking

mental health

services.
There are some doctors that refuse insurance altogether, preferring to be on-call for private citizens willing to pay a hefty fee. These are known as

concierge doctors

, and they are becoming more popular in high-income communities.

What are the consequences of doctors refusing to accept Medicare patients?

If a doctor decides not to accept Medicare, then they will no longer be eligible for reimbursements from the program. However, this does not mean that these doctors cannot see Medicare patients. It simply means that the patient will need to pay out-of-pocket for any services they receive from this doctor and then submit a claim to Medicare for reimbursement. In some cases, doctors may also be fined or penalized for refusing to accept Medicare patients.

How can people find a doctor who accepts Medicare patients?

The best way to find a doctor who accepts Medicare is to use the "Find a Doctor" tool on Medicare's website. This tool allows you to search for doctors in your area who accept Medicare and meets other criteria, such as their specialty and language spoken. Additionally, many hospitals and healthcare facilities have lists of doctors who are participating providers with Medicare. You can also call your local Medicare office to get more information about finding a doctor who accepts Medicare.

What if your doctor doesn't accept Medicare?

If your doctor doesn't accept Medicare, you should ask them why they are not participating in the program. Your doctor may be able to offer alternative solutions that would make it possible for you to receive care from them while still receiving reimbursement from Medicare. If you receive care and they have opted-out of Medicare, you could be responsible for the full cost of the treatment out-of-pocket.
You can use the "Find a Doctor" tool on Medicare's website to search for doctors in your area who accept Medicare. You can also contact your local medical society or hospital to find a list of doctors who are participating providers with Medicare. Finally, you can call 1-800-MEDICARE (1-800-633-4227) to speak with a representative and get more information on how to find doctors who accept Medicare.

Conclusion

A growing number of doctors may choose to opt-out of Medicare. For Medicare beneficiaries, it's important to make sure your doctor accepts Medicare. Otherwise, you could pay for your treatment out-of-pocket. For all your Medicare-related questions, talk with an expert at

Fair Square Medicare

.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Costco & Fair Square
Costco Pharmacy Partners with Fair Square
Jan 13, 2023
Closeup of a male Doctor or physiotherapist doing stretching for a patient in the clinic for examining treating injured of back stock photo
Does Medicare Cover Chiropractic Visits?
Dec 22, 2022
COVID-19 at home test stock image
Does Medicare Cover COVID Tests?
Dec 21, 2022
Cover image
What People Don't Realize About Medicare
Mar 27, 2023
Physiotherapist showing workout record on exercise bike
Does Medicare Cover Exercise Physiology?
Jan 11, 2023
Dripping medication stock photo
Does Medicare Cover Ketamine Infusion for Depression?
Nov 23, 2022
Psoriasis on elbow stock photo
Does Medicare Cover Ilumya?
Dec 7, 2022
Teenager Helping his Grandfather at Home stock photo
Does Medicare Cover Geri Chairs?
Dec 7, 2022
What is the ICEP?
What is the Medicare ICEP?
Apr 7, 2023
Cover image
How Are Medicare Star Ratings Determined?
Sep 6, 2023
Emergency section of a hospital exterior stock photo
How Does Medicare Pay for Emergency Room Visits?
Nov 21, 2022
Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo
Does Medicare Cover Kyphoplasty?
Dec 9, 2022
treehouse
Medigap vs. Medicare Advantage
May 25, 2020
senior man holding out his medicare card stock image
Can I Laminate My Medicare Card?
Dec 22, 2022
Leg bones and knees, 3d rendering. stock photo
Does Medicare Cover Boniva?
Nov 29, 2022
Cover image
What To Do If Your Medicare Advantage Plan Is Discontinued
Feb 26, 2024
surgeons working over a patient stock image
Does Medicare Cover LVAD Surgery?
Nov 30, 2022
Cover image
2024 Cost of Living Adjustment
Nov 13, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

14 Best Ways for Seniors to Stay Active in Seattle

14 Best Ways to Stay Active in Charlotte

20 Questions to Ask Your Medicare Agent

2024 Fair Square NPS Report

Building the Future of Senior Healthcare

Can I Choose Marketplace Coverage Instead of Medicare?

Can Medicare Help with the Cost of Tyrvaya?

Comparing All Medigap Plans | Chart Updated for 2025

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Abortion Services?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Fosamax?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare cover Hyoscyamine?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Inqovi?

Does Medicare Cover Krystexxa?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mental Health?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Ofev?

Does Medicare Cover Ozempic?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover PTNS?

Does Medicare Cover Qutenza?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Tymlos?

Does Medicare Cover Wart Removal?

Does Medicare Cover Zilretta?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Allergy Shots?

Does Medicare Pay for Funeral Expenses?

Does Medicare Pay for Varicose Vein Treatment?

Does Your Plan Include A Free Gym Membership?

Fair Square Bulletin: We're Revolutionizing Medicare

Finding the Best Vision Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Do Medicare Agents Get Paid?

How Do Medigap Premiums Vary?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Often Can I Change Medicare Plans?

How Your Employer Insurance and Medicare Work Together

Is Botox Covered by Medicare?

Is Emsella Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is Gainswave Covered by Medicare?

Is HIFU Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare 101

Medicare Explained

Medicare Savings Programs in Kansas

Medicare Supplement Plans for Low-Income Seniors

The Easiest Call You'll Ever Make

What Are Medicare Part B Excess Charges?

What Does Medicare Cover for Stroke Patients?

What is a Medicare Beneficiary Ombudsman?

What is the 8-Minute Rule on Medicare?

What's the Deal with Flex Cards?

What's the Difference Between HMO and PPO Plans?

Which Medigap Policies Provide Coverage for Long-Term Care?

Why Is Medicare So Confusing?

Will Medicare Cover it?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M