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How Many Doctors Accept Medicare?

How Many Doctors Accept Medicare?

Before Medicare, many of us felt comfortable staying within the networks of doctors we were dealt with and worked around the stipulations of having to obtain referrals when additional care was needed. Do all doctors accept medicare? Almost! Now over 93%, of all doctors in America accept Medicare, meaning you get a lot more freedom when choosing a doctor.

Medicare Doctors

If you participate in Original Medicare coverage, you have the largest network of providers available to you. So, if you want to see the best cardiologist, or utilize the services of the best hospital, chances are they are in-network. 

Though not all doctors accept Medicare, it’s an insignificant probability you will encounter it on your day to day medical visits. Despite this, be sure to find out if: 

  • you can continue to see your current doctor
  • which doctors you may need are leaving the Medicare network
  • if your doctor will drop you if you switch to a Medicare plan

The Three Categories of Medicare Doctors:

Medicare practitioners break down into one of three categories:

  • Participating doctors who accept Medicare: They take Medicare assignments and only charge the sum in which Medicare allows.
  • Non-Participating doctors: These doctors can choose if they want to accept Medicare assignments or not. They may take your Medicare but can charge over the total amount Medicare covers, up to 15%. They may not price their services at a higher amount but have the right to do so.
  • Doctors who have opted out of the Medicare network: While they are in the minority, you sometimes come across them. These refuse to take any form of Medicare coverage and can charge whatever they want. You will be left to pay for the entire bill. 

Does A Medicare Supplement Plan Impact Your Network of Doctors?

Possessing a Medicare Supplement plan will not impact your Network of doctors. 

How Does Having a Medicare Advantage Plan Impact Your Doctor Network

Unlike a Medicare Supplement, a Medicare Advantage Plan replaces your Original Medicare, as it’s taken over entirely by an insurance company. Because of this, you do not have the freedom to book just any doctor that accepts Medicare. With a Medicare Advantage Plan, you are subject to specific networks within your plan, along with rules for referrals or additional medical services. 

Some Medicare Advantage Plans offer Preferred Provider (PPO) Networks for purchase. These allow you to visit doctors out of your Network. They do not have to abide by your plan’s rates, and will likely be subjected to out-of-pocket costs. 

This, along with co-pays, co-insurance, deductibles, and maximum out-of-pocket costs are significantly higher when you use out-of-network benefits.

How Can I Find Out Which Doctor Takes Medicare? 

On the Medicare.gov site, you can find many tools to help you find a doctor that accepts Medicare assignments. The easiest way to find out which practitioner participates in Medicare is to check their Physician Compare tool.

You can also call a licensed Medicare at 1-877-829-1109. A customer representative will help you locate a doctor who accepts Medicare near you!