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

Doctor physician consulting with male patient in hospital exam room stock photo
Is Gainswave Covered by Medicare?
Dec 6, 2022
Seattle Public Market stock image
14 Best Ways for Seniors to Stay Active in Seattle
Mar 10, 2023
Cover image
What People Don't Realize About Medicare
Mar 27, 2023
Medicare Set Aside funds stock image
What Happens to Unused Medicare Set-Aside Funds?
Jan 20, 2023
Black debit card changing hands against a yellow background stock image
What's the Deal with Flex Cards?
Dec 15, 2022
Cover image
2023 Medicare Annual Election Period (AEP)
Sep 21, 2023
Cover image
2024 Cost of Living Adjustment
Nov 13, 2023
Cover image
How to Become a Medicare Agent
Aug 30, 2023
scientist mixing chemical compounds stock image
Does Medicare Cover Compounded Medications?
Apr 4, 2023
Plastic surgeon handles a silicon implant
Does Medicare Cover Breast Implant Removal?
Jan 5, 2023
Heart on Heart Rhythm Background Concept stock photo
Does Medicare Cover the WATCHMAN Procedure?
Dec 1, 2022
Cover image
Can I Choose Marketplace Coverage Instead of Medicare?
May 2, 2023
Illustrated referential images of a hospital bill, coins, cash in a wallet, a calculator, and a magnifying glass
What Are Medicare Part B Excess Charges?
Jan 6, 2023
Cover image
What To Do If Your Medicare Advantage Plan Is Discontinued
Feb 26, 2024
Rattlesnake biting on a hiker's boot stock image
Does Medicare Pay for Antivenom?
Dec 6, 2022
Medicare at 62 stock image
Does Retiring at Age 62 Make Me Eligible for Medicare?
Jun 16, 2022
Cover image
How Are Medicare Star Ratings Determined?
Sep 6, 2023
Male doctor with his arms crossed stock image
Can Doctors Choose Not to Accept Medicare?
Dec 8, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Philadelphia

14 Best Ways for Seniors to Stay Active in Washington, D.C.

15 Best Ways for Seniors to Stay Active in Denver

20 Questions to Ask Your Medicare Agent

2024 "Donut Hole" Updates

2024 Medicare Price Changes

Can I switch From Medicare Advantage to Medigap?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Help with the Cost of Tyrvaya?

Comparing All Medigap Plans | Chart Updated for 2023

Costco Pharmacy Partners with Fair Square

Do Medicare Supplement Plans Cover Dental and Vision?

Does Medicare Cover Abortion Services?

Does Medicare Cover Air Purifiers?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover COVID Tests?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Ilumya?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Krystexxa?

Does Medicare Cover Light Therapy for Psoriasis?

Does Medicare Cover Lipoma Removal?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Macular Degeneration?

Does Medicare Cover Nexavar?

Does Medicare Cover Nuedexta?

Does Medicare Cover Ofev?

Does Medicare Cover Piqray?

Does Medicare Cover Service Animals?

Does Medicare Cover Wart Removal?

Does Medicare Cover Xiafaxan?

Does Medicare Pay for Allergy Shots?

Does Your Plan Include A Free Gym Membership?

Everything About Your Medicare Card + Medicare Number

Fair Square Client Newsletter: AEP Edition

Finding the Best Vision Plans for Seniors

How Can I Get a Replacement Medicare Card?

How Does Medicare Pay for Emergency Room Visits?

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

How Medicare Costs Can Pile Up

How Much Does a Medicare Coach Cost?

How Much Does Medicare Cost?

How Much Does Open Heart Surgery Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How to Choose a Medigap Plan

How to Deduct Medicare Expenses from Your Taxes

Is Balloon Sinuplasty Covered by Medicare?

Is PAE Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Medicare 101

Medicare Advantage Plans for Disabled People Under 65

Medicare Supplement Plans for Low-Income Seniors

Medigap vs. Medicare Advantage

Saving Money with Alternative Pharmacies & Discount Programs

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: November 2023

Top 10 Physical Therapy Clinics in San Diego

What Does Medicare Cover for Stroke Patients?

What is the 8-Minute Rule on Medicare?

What to Do When Your Doctor Doesn't Take Medicare

What You Need to Know About Creditable Coverage

Why Is Medicare So Confusing?

Will Medicare Cover Dental Implants?

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 2023

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. © 2022 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