If you’re a Medicare beneficiary, the good news is that most doctors in the U.S. do accept Medicare — particularly primary care providers. However, confirming that your specific doctor is in-network is always a smart move, especially if you’re seeing a specialist for the first time.

To make sure you’re covered, contact the doctor’s office directly and provide your Medicare information, or reach out to your Medicare insurance provider for assistance.

Statistically, about 93% of non-pediatric primary care physicians accept Medicare, which is nearly identical to the 94% who take private insurance. But whether you’re already a patient, the type of Medicare plan you have, and the provider’s current policies can affect access.

Here’s how to find doctors who accept Medicare and what to do if yours doesn’t.

How to Find Medicare-Approved Doctors

Medicare offers an online tool called Physician Compare to help you search for doctors and medical facilities that participate in the Medicare program. You can access this at Medicare.gov, or you can call 1-800-MEDICARE for help.

If you’re enrolled in a Medicare Advantage plan, use your provider’s website or contact customer service to search for doctors within your plan’s network.

These tools typically let you filter your search based on:

• Location (city, state, or ZIP code)

• Medical specialty or condition

• Provider’s gender

• Affiliated hospitals

• Doctor’s last name

Even after using these resources, it’s still a good idea to call the provider’s office directly to verify that they take Medicare — and to confirm they’re accepting new Medicare patients.

Why Some Doctors Don’t Accept Medicare

Some providers opt out of Medicare for a variety of reasons, including administrative challenges and lower reimbursement rates. If your doctor decides to stop participating in Medicare, you may need to either pay out of pocket or switch to a provider who remains in the program.

Doctors who are enrolled in Medicare but do not accept assignment for all services are known as non-participating providers. These providers can choose on a case-by-case basis whether to accept Medicare’s approved payment amount for a service.

If Your Doctor Doesn’t Accept Medicare

Non-participating providers may charge more than the Medicare-approved rate. In most cases, this means you could pay up to 15% more than the standard rate. This extra cost is known as a limiting charge.

Some states restrict this additional charge — capping it at 5% instead of 15%. Regardless, these charges are on top of your usual 20% coinsurance, which can add up quickly.

Doctors may ask for these payments at the time of service or send you a bill afterward. Be sure to ask about their billing policies before your visit so you’re not caught off guard.

If you pay out of pocket, you can submit a claim to Medicare for reimbursement — you have up to one year from the date of service to do so.

Bottom Line

While the vast majority of doctors accept Medicare, especially in primary care, it’s always best to double-check. Call ahead, confirm your provider’s status, and understand your financial responsibilities before receiving care. If your current doctor opts out of Medicare, ask how it impacts your coverage and explore your alternatives to stay protected.