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

The Easiest Call You'll Ever Make

Jun 28, 2023

Medsupp Thumbnail

Plan G vs. Plan N

Jan 28, 2022

Cover image

How Are Medicare Star Ratings Determined?

Sep 6, 2023

Cover image

Medicare Advantage MSA Plans

May 17, 2023

Cover image

What Is a Medicare Advantage POS Plan?

May 10, 2023

Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo

Does Medicare Cover Oxybutynin?

Dec 2, 2022

Medicare at 62 stock image

Does Retiring at Age 62 Make Me Eligible for Medicare?

Jun 16, 2022

Acute psoriasis on elbows is an autoimmune incurable dermatological skin disease stock photo

Does Medicare Cover Light Therapy for Psoriasis?

Jan 17, 2023

Cover image

Will Medicare Cover it?

Oct 3, 2023

Senior man receiving care from an optometrist stock photo

Does Medicare Cover Cataract Surgery?

Dec 22, 2022

senior man reaching to his ear with jumbled letters going into the ear stock image

Does Medicare Cover Hearing Aids?

Nov 9, 2022

Fair Square

Is Displacement Affecting Your Medicare Coverage?

Oct 6, 2022

Senior couple going over their finances stock photo

Explaining IRMAA on Medicare

Dec 21, 2022

Fair Square

Building the Future of Senior Healthcare

Aug 25, 2022

The feet of a man suffering from foot pain stock photo

Does Medicare Cover Krystexxa?

Nov 18, 2022

Myelofibrosis stock image

Does Medicare Cover Jakafi?

Dec 12, 2022

Close up of a senior clutching their right wrist in pain stock photo

Does Medicare Cover Cala Trio?

Nov 23, 2022

Human hands holding healthy lung shape made from paper on light blue background. stock photo

How Much Does Trelegy Cost with Medicare?

Jan 24, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Philadelphia

13 Best Ways for Seniors to Stay Active in Phoenix

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

Are Medicare Advantage Plans Bad?

Can Doctors Choose Not to Accept Medicare?

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

Can I Change My Primary Care Provider with an Advantage Plan?

Can I Have Two Primary Care Physicians?

Can I Use Medicare Part D at Any Pharmacy?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Denied Coverage? What to Do When Your Carrier Says No

Do I Need to Renew My Medicare?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Exercise Physiology?

Does Medicare Cover Flu Shots?

Does Medicare Cover Fosamax?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Inqovi?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Macular Degeneration?

Does Medicare Cover Ofev?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover Piqray?

Does Medicare Cover Qutenza?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover Vitamins?

Does Medicare Cover Xiafaxan?

Does Medicare Cover Zilretta?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Bunion Surgery?

Does Your Medicare Plan Cover B12 Shots?

Estimating Prescription Drug Costs

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 Rexulti Cost with Medicare?

How Often Can I Change Medicare Plans?

How to Become a Medicare Agent

How to Choose a Medigap Plan

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 PAE Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare 101

Medicare Advantage Plans for Disabled People Under 65

Medicare Deductibles Resetting in 2025

Medicare Explained

Moving? Here’s What Happens to Your Medicare Coverage

Top 10 Physical Therapy Clinics in San Diego

Turning 65 and Thinking of Keeping COBRA? Here’s Why It Usually Backfires

Welcome to Fair Square's First Newsletter

What Happens to Unused Medicare Set-Aside Funds?

What is Plan J?

What is the 8-Minute Rule on Medicare?

What Is the Medicare Birthday Rule in Nevada?

What is the Medicare ICEP?

What You Need to Know About Creditable Coverage

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?

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

Fair Square Medicare

FSM symbol - 50