The majority of doctors, especially primary care physicians, do accept Medicare. However, it’s always a good idea to confirm coverage before your appointment, particularly if you’re seeing a specialist.

You can verify this by calling the doctor’s office and providing your Medicare information or by contacting your Medicare plan provider directly.

In fact, about 93% of non-pediatric primary care doctors accept Medicare, which is very close to the 94% acceptance rate for private insurance. That said, acceptance can vary depending on the type of Medicare coverage you have and whether you are a current patient.

How to Find Medicare-Approved Doctors

Medicare’s website features a tool called Physician Compare that lets you search for doctors and facilities enrolled in Medicare. You can also call 1-800-MEDICARE to speak with a representative.

If you’re enrolled in a Medicare Advantage plan, your plan provider’s website or customer service can help you find doctors who accept your coverage.

Most search tools let you filter results by:

• Medical specialty or condition

• Location or ZIP code

• Doctor’s last name

• Gender

• Hospital affiliation

It’s always smart to call the doctor’s office afterward to confirm they accept Medicare and are accepting new patients.

Why Some Doctors Don’t Accept Medicare

Some doctors may choose to stop accepting Medicare, often due to reimbursement rates or administrative challenges. If that happens, you can either pay out of pocket or look for a different provider who accepts Medicare.

Doctors who don’t accept Medicare’s payment rates for all services are called non-participating providers. They’re enrolled in Medicare but can decide whether or not to accept the Medicare-approved amount on a case-by-case basis.

What Happens If Your Doctor Doesn’t Accept Medicare

Non-participating doctors can charge up to 15% more than Medicare’s approved payment rate—known as a limiting charge. Some states limit this extra charge to 5%.

This fee is in addition to the usual 20% coinsurance Medicare requires.

Doctors may require payment during your visit or send a bill afterward. To avoid surprises, check payment policies before your appointment.

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

The Bottom Line

Most doctors accept Medicare, but it’s always wise to verify before your visit. If your doctor stops accepting Medicare, ask about the impact on your care and explore your options to avoid unexpected costs.