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.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

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

.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Recommended Articles

Cover image

Fair Square Bulletin: We're Revolutionizing Medicare

Apr 27, 2023

Unrecognizable doctor holding highlighted handrawn Kidneys in hands. Medical illustration, template, science mockup. stock photo

Does Medicare Cover Nexavar?

Nov 30, 2022

Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo

Does Medicare Cover SI Joint Fusion?

Nov 28, 2022

Indianapolis skyline at night stock image

13 Best Ways for Seniors to Stay Active in Indianapolis

Mar 9, 2023

Doctor demonstrating upper cervical spine anatomy stock photo

Does Medicare Cover Cervical Disc Replacement?

Jan 20, 2023

Cover image

How Much Does a Medicare Coach Cost?

Mar 20, 2023

Female physiotherapist helping elderly man in wheelchair do exercises with dumbbells at health center stock photo

What Does Medicare Cover for Stroke Patients?

Jan 20, 2023

Sleep apena stock image

Does Medicare Cover Inspire for Sleep Apnea?

Dec 27, 2022

Cover image

Medicare Deductibles Resetting in 2025

Jan 18, 2024

Orthopaedist at work treating a bunion, stock photo

Does Medicare Pay for Bunion Surgery?

Nov 29, 2022

Fecal microbiota transplant from healthy in unhealthy intestine, FMT. Improvement intestinal microflora and normalization stool by introducing beneficial bacteria in bowel colon tract. Vector stock illustration

Does Medicare Cover an FMT?

Dec 2, 2022

Kidney stone stock image

Does Medicare Cover Kidney Stone Removal?

Nov 23, 2022

pros and cons stock image

Are Medicare Advantage Plans Bad?

May 5, 2022

Black debit card changing hands against a yellow background stock image

What's the Deal with Flex Cards?

Dec 15, 2022

senior man experiencing discomfort stock image

Does Medicare Cover Linx Surgery?

Dec 6, 2022

Model of the lungs with the diseased part stock photo

Does Medicare Cover Ofev?

Dec 2, 2022

Nashville city skyline stock image

14 Best Ways for Seniors to Stay Active in Nashville

Mar 10, 2023

older man suffering from stomach pain due to IBS stock photo

Does Medicare Cover Xiafaxan?

Jan 19, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Jacksonville

15 Best Ways for Seniors to Stay Active in Denver

2024 Cost of Living Adjustment

2024 Fair Square NPS Report

Building the Future of Senior Healthcare

Can Doctors Choose Not to Accept Medicare?

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Can I switch From Medicare Advantage to Medigap?

Can I Use Medicare Part D at Any Pharmacy?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Help with the Cost of Tyrvaya?

Comparing All Medigap Plans | Chart Updated for 2025

Costco Pharmacy Partners with Fair Square

Does Medicare Cover Air Purifiers?

Does Medicare Cover Boniva?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare Cover Compounded Medications?

Does Medicare Cover COVID Tests?

Does Medicare Cover Diabetic Eye Exams?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Krystexxa?

Does Medicare Cover Light Therapy for Psoriasis?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Ozempic?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover PTNS?

Does Medicare Cover TENS Units?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Tymlos?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Require a Referral for Audiology Exams?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Does Your Plan Include A Free Gym Membership?

Explaining the Different Enrollment Periods for Medicare

Finding the Best Dental Plans for Seniors

How Are Medicare Star Ratings Determined?

How is Medicare Changing in 2025?

How Medicare Costs Can Pile Up

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Part A Cost in 2025?

How Much Does Medicare Part B Cost in 2025?

How to Enroll in Social Security

Is Botox Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is HIFU Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Medicare & Ozempic

Medicare Consulting Services

Medicare Explained

Medigap vs. Medicare Advantage

Plan G vs. Plan N

The Easiest Call You'll Ever Make

What Happens to Unused Medicare Set-Aside Funds?

What If I Don't Like My Plan?

What Is Medical Underwriting for Medigap?

What is the 8-Minute Rule on Medicare?

What is the Medicare ICEP?

What People Don't Realize About Medicare

What to Do When Your Doctor Leaves Your Network

What You Need to Know About Creditable Coverage

When to Choose Medicare Advantage over Medicare Supplement

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