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
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.
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
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
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.
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.
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.
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
Does Medicare Cover Ofev?
Dec 2, 2022
Does Medicare Pay for Bunion Surgery?
Nov 29, 2022
Does Medicare Cover Qutenza?
Jan 13, 2023
Does Medicare Cover Hearing Aids?
Nov 9, 2022
How to Apply for Medicare?
Jul 15, 2022
Fair Square Bulletin: We're Revolutionizing Medicare
Apr 27, 2023
Does Medicare Cover Medical Marijuana?
Jan 6, 2023
Denied Coverage? What to Do When Your Carrier Says No
Jul 15, 2025
How Much Does a Medicare Coach Cost?
Mar 20, 2023
Explaining the Different Enrollment Periods for Medicare
Feb 3, 2023
Does Medicare Cover Bladder Sling Surgery?
Jan 11, 2023
How Do Medicare Agents Get Paid?
Apr 12, 2023
How Are Medicare Star Ratings Determined?
Sep 6, 2023
Is Fair Square Medicare Legitimate?
Jul 27, 2023
How Often Can I Change Medicare Plans?
May 5, 2023
Does Medicare Cover Cataract Surgery?
Dec 22, 2022
Does Medicare Cover the Urolift Procedure?
Dec 6, 2022
What People Don't Realize About Medicare
Mar 27, 2023
13 Best Ways for Seniors to Stay Active in Jacksonville
14 Best Ways for Seniors to Stay Active in Nashville
14 Best Ways for Seniors to Stay Active in Seattle
14 Best Ways for Seniors to Stay Active in Washington, D.C.
14 Best Ways to Stay Active in Charlotte
20 Questions to Ask Your Medicare Agent
Building the Future of Senior Healthcare
Can I Have Two Primary Care Physicians?
Can I Use Medicare Part D at Any Pharmacy?
Costco Pharmacy Partners with Fair Square
Do Medicare Supplement Plans Cover Dental and Vision?
Does Medicare Cover Abortion Services?
Does Medicare Cover Boniva?
Does Medicare Cover Cardiac Ablation?
Does Medicare Cover Cartiva Implants?
Does Medicare Cover Cervical Disc Replacement?
Does Medicare Cover Cosmetic Surgery?
Does Medicare Cover COVID Tests?
Does Medicare Cover Diabetic Eye Exams?
Does Medicare Cover Disposable Underwear?
Does Medicare Cover Driving Evaluations?
Does Medicare Cover ESRD Treatments?
Does Medicare Cover Exercise Physiology?
Does Medicare Cover Flu Shots?
Does Medicare Cover Fosamax?
Does Medicare Cover Hepatitis C Treatment?
Does Medicare Cover Hoarding Cleanup?
Does Medicare Cover Inqovi?
Does Medicare Cover Iovera Treatment?
Does Medicare Cover Krystexxa?
Does Medicare Cover Kyphoplasty?
Does Medicare Cover Light Therapy for Psoriasis?
Does Medicare Cover Macular Degeneration?
Does Medicare Cover Mental Health?
Does Medicare Cover Mouth Guards for Sleep Apnea?
Does Medicare Cover Nuedexta?
Does Medicare Cover Ozempic?
Does Medicare Cover Physicals & Blood Work?
Does Medicare Cover Piqray?
Does Medicare Cover Service Animals?
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Does Medicare Cover Stair Lifts?
Does Medicare Cover Tymlos?
Does Medicare Cover Urodynamic Testing?
Does Medicare Cover Wart Removal?
Does Medicare Have Limitations on Hospital Stays?
Does Medicare Pay for Allergy Shots?
Does Medicare Pay for Varicose Vein Treatment?
Does Retiring at Age 62 Make Me Eligible for Medicare?
Finding the Best Vision Plans for Seniors
How Do I Sign up for Medicare? A Simple How-To Guide For You
How Do Medigap Premiums Vary?
How Does Medicare Pay for Emergency Room Visits?
How is Medicare Changing in 2025?
How to Become a Medicare Agent
How to Choose a Medigap Plan
How to Deduct Medicare Expenses from Your Taxes
Is Displacement Affecting Your Medicare Coverage?
Is PAE Covered by Medicare?
Is the Shingles Vaccine Covered by Medicare?
Is Vitrectomy Surgery Covered by Medicare?
Medicare Deductibles Resetting in 2025
Medicare Savings Programs in Kansas
Medicare Supplement Plans for Low-Income Seniors
Moving? Here’s What Happens to Your Medicare Coverage
The Easiest Call You'll Ever Make
Welcome to Fair Square's First Newsletter
What Are Medicare Part B Excess Charges?
What is Plan J?
What is the Medicare ICEP?
When to Choose Medicare Advantage over Medicare Supplement
Will Medicare Cover Dental Implants?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
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
Fair Square Medicare