Most primary care doctors do accept Medicare.
However, it’s always best to verify your coverage before your appointment — especially if you’re visiting a specialist. You can check by calling the doctor’s office and providing your Medicare details, or by contacting your Medicare provider directly.

In general, the answer is yes. Approximately 93% of non-pediatric primary care physicians accept Medicare, which is nearly identical to the 94% who accept private insurance. That said, acceptance can depend on the type of Medicare plan you have and whether you’re already an established patient.

Here’s what you should know about Medicare coverage and how to confirm if you’re covered.

How to Find a Doctor Who Accepts Medicare

The Medicare website offers a helpful tool called Physician Compare, which allows you to search for doctors and healthcare facilities that participate in Medicare. You can also call 800-MEDICARE to speak with a representative for assistance.

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

Most of these search tools let you filter results by:

• Medical specialty or condition

• Body part or organ system

• ZIP code or location

• Doctor’s name

• Gender

• Hospital affiliation

After using these tools, always call the doctor’s office to confirm that they accept Medicare and are currently taking new Medicare patients.

Why Some Doctors Might Not Accept Medicare

There are several reasons a doctor may choose not to accept Medicare. If this happens, you can either pay out of pocket to continue care or look for another provider who does accept it.

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

What to Do If Your Doctor Doesn’t Take Medicare

Doctors who participate in Medicare must charge no more than the Medicare-approved amount. Non-participating providers, however, may charge up to 15% more than that rate. Some states restrict this limiting charge to 5%, in addition to the standard 20% coinsurance.

Depending on the doctor’s policy, you may need to pay these charges upfront or after your visit. Be sure to ask about payment requirements before your appointment so you know what to expect.

If you do pay out of pocket, you have one year to submit a claim to Medicare for possible reimbursement.

Bottom Line

While most doctors accept Medicare, it’s always smart to confirm before your visit. If your provider ever stops taking Medicare, ask how it impacts your plan and explore your options to make sure you remain financially protected.