The majority of primary care physicians participate in Medicare.
Still, it’s important to verify your coverage before any appointment — especially if you’re seeing a specialist. You can do this by contacting the doctor’s office and giving them your Medicare details or by reaching out to your Medicare provider directly.

In short, yes, most doctors accept Medicare. About 93% of non-pediatric primary care physicians accept Medicare, a figure very close to the 94% who accept private insurance. However, participation may vary based on your specific Medicare plan and whether you’re already an existing patient.

Read on to learn more about Medicare coverage and how to confirm whether you’ll be covered.

Finding a Doctor Who Accepts Medicare

The official Medicare website provides a search tool called Physician Compare, which lets you look up doctors and healthcare facilities enrolled in Medicare. You can also call 800-MEDICARE to speak with a representative.

If you have a Medicare Advantage plan, you can contact your plan provider directly or use their online member portal to find in-network doctors.

These tools typically allow you to search by:

• Medical specialty or condition

• Body part or organ system

• Location or ZIP code

• Doctor’s name

• Gender

• Hospital affiliation

Even after using these tools, it’s a good idea to call the office to confirm that they accept Medicare and are taking new Medicare patients.

Reasons Some Doctors Don’t Accept Medicare

Some physicians may choose not to accept Medicare for financial or administrative reasons. If your doctor stops taking Medicare, you can continue to see them by paying out of pocket or find another provider who does accept it.

Doctors who have not signed an agreement to accept assignment (the approved amount Medicare pays for covered services) are known as non-participating providers. They are still enrolled in Medicare but can decide on a case-by-case basis whether to accept Medicare’s approved payment amount.

What to Do If a Doctor Doesn’t Take Medicare

Providers who fully participate in Medicare cannot charge more than the Medicare-approved amount. However, non-participating doctors can bill up to 15% more than that amount — a difference known as a limiting charge. In some states, this limit is capped at 5% above the approved rate, in addition to your standard 20% coinsurance.

Some offices may ask for payment at the time of your appointment, while others may bill you afterward. Always confirm the office’s payment policy beforehand so you know what to expect.

If you pay out of pocket, you have one year to file a reimbursement claim with Medicare.

Key Takeaway

Most healthcare providers accept Medicare, but it’s always best to confirm before your visit. If your doctor stops participating, ask how it might affect your coverage and what alternatives you have to stay protected financially.