Not all doctors accept Medicare. When a doctor does accept Medicare, this means they have accepted the assignment. However, there are still out-of-pocket costs for you to consider.
There are various ways to check whether your doctor accepts Medicare. It’s a good idea to check this before you make an appointment.
Glossary of common Medicare terms
- Premiums: The monthly amount you pay to use Medicare coverage plans.
- Deductibles: The annual amount you must spend out of pocket before the insurer will begin to cover services and treatments.
- Coinsurance: The percentage of treatment costs you’re responsible for paying out of pocket. With Medicare Part B, this is typically 20%.
- Copayment: The fixed dollar amount you must pay when receiving certain treatments or services. With Medicare, this often applies to prescription medications.
If your doctor or another healthcare professional or provider agrees to accept the Medicare-approved amount as full payment for services, they are accepting the assignment.
Most doctors do accept the assignment. However, it’s a good idea to check before going to your appointment.
If they do accept the assignment, this means:
- out-of-pocket costs may be less
- the doctor’s office submits the claim directly to Medicare and cannot charge you to submit it
- the doctor agrees to only charge you for the Medicare coinsurance and deductible; they also typically charge Medicare first before asking you for your share
When a doctor accepts an assignment, it’s for all services and treatments that are covered by Medicare Part A and Part B.
Read more about Medicare coverage for doctors’ visits.
If your doctor is a nonparticipating provider, this means they may accept Medicare but do not accept the assignment in all cases. They may accept it on a case-by-case basis.
Nonparticipating providers have signed up to accept Medicare but do not accept the Medicare-approved amount as full payment. They can charge up to 15% more than the Medicare-approved amount for their services. This is known as a limiting charge. Some states may limit the limiting charge.
If you pay the full cost of services upfront, the provider should still submit a claim to Medicare. After this, you should receive a Medicare Summary Notice (MSN) and a reimbursement for 80% of the Medicare-approve amount.
Finding doctors who accept Medicare
To find a doctor who accepts Medicare, you can visit the Medicare website.
On the website, you can search for a doctor based on:
- location
- last name of the doctor
- keyword relating to a condition or specialty
The search results will give a list of doctors in your area who accept Medicare.
An opt-out provider does not accept Medicare at all. They have signed an agreement so they can be excluded from the Medicare system.
This means they can charge whatever they want for their services while following certain rules. This also means:
- Medicare will not pay for any services you receive from an opt-out provider. You are responsible for all costs.
- Opt-out providers do not bill Medicare for any of their services.
- They must give you a contract that states all charges and confirm that you understand you are responsible for all costs and that Medicare will not reimburse you.
Read about the 2025 Medicare guidelines.
Most doctors accept Medicare and agree to accept the Medicare-approved amount as full payment for services. This means they are accepting the assignment.
However, doctors also have the option to be nonparticipating providers, which means they accept Medicare but do not agree to take the Medicare-approved amount as full payment.
Doctors also have the option to opt out of Medicare altogether. This means they do not accept Medicare at all.
You can find doctors who accept Medicare in your area by searching on Medicare.gov.