Doctors Not Accepting Your Medicare? Here’s What You Can Do!

Doctors Not Accepting Your Medicare? Here’s What You Can Do!

June 18, 2020 Off By akhilesh

Doctors Not Accepting Your Medicare

There is nothing better than having a medical plan in place. Healthcare programs like Medicare not just aids individuals but also saves them a lot of money. Unfortunately, not every doctor out there takes Medicare from patients. As a result, the patients have to pay hefty out-of-pocket costs. However, we are here with some effective options one can consider in such cases to avoid burning a hole in his or her pocket. 

Today, most people have a single doctor and they might be visiting this doctor for more than 20 years. In this case, the doctor might know you inside and out. He or she will know what works best for you and whatnot, which is exactly the foremost reason you are still visiting him or her. 

But it may really break one’s heart when they learn that his or her favorite doctor does not accept a Medicare plan. If you are also one of them, this blog is meant for you, my friend! 

Keep reading! 


First thing first, one should have a clear picture of Medicare. So, it is a well-known healthcare program sponsored by the federal government. 

Medicare provides medical insurance for all the citizens of America who are aged 65 and more. 

In the year 1965, President Lyndon B. Johnson signed Medicare into law and in the following year, 19 million American citizens enrolled in it.

Today, the aforementioned number has increased to over 57 million, which is more than 18 percent of the United States population. 

Also Check: 5 Reasons why Medicare is necessary

Solutions When Your Doctor Says No To Medicare

Due to the federal program’s low reimbursement rates, stringent rules, and grueling paperwork process, various doctors in America have started to refuse Medicare’s payment for services. 

In the year 2000, about 80 percent of the Texas Medical Association’s doctors accepted new Medicare patients. But in the year 2012, that number was dipped down to less than 60 percent.

Medicare basically pays doctors a total of 80 percent of what private health insurance pays. A number of doctors feel that Medicare reimbursements have not kept pace with inflation in the past several years, particularly the expenses of running a medical practice. Needless to mention, the rules & regulations also get heavier, as do penalties for not complying with them. 

So, here are some of the options you can consider if your doctor doesn’t accept Medicare:

  • Stay Put & Pay The Difference

If your doctor is not taking Medicare, then it may be because he or she has not yet signed an agreement to accept assignment for all Medicare-covered services. However, he or she can still take an assignment for an individual patient. 

In simpler words, doctors may take Medicare patients but not concur with the program’s reimbursement rates. Such doctors are normally termed as nonparticipating providers and they can charge about 15 percent over the official Medicare reimbursement amount. 

  • Request A Discount

In case your physician is an opt-out provider, then he or she may be ready to accept Medicare patients but at the same time, they also expect to be paid his or her full fees. So, in this case, you should request for a possible discount. Being your doctor for so many years, he or she is likely to give you a good discount. 

Also Check: Best Medicare Advantage Plans For 2020

  • Go To An Urgent Care Center 

Urgent care centers are a well-known place where people go to fulfill their health care requirements. As per the American Association of Pediatrics, there are over 4,000 to 9,000 urgent care centers in the United States.  So, if you have any minor illness you should avoid going to a doctor and consider one of these clinics. 

  • Ask Your Doctor For A Referral 

If nothing works out and you just cannot afford your favorite doctor, then you should consider anyone else at the earliest. To make your task a little bit easier, ask your doctor to recommend some excellent doctor in your area who does take Medicare. 

  • Search Via Medicare’s Directory 

Just because your doctor doesn’t accept Medicare, it doesn’t mean that no doctors in the U.S accept the same. You can find a number of doctors who accept Medicare. 

Just invest some time and check in the Medicare’s Physician Compare directory. It will provide you a long list of doctors & healthcare providers around the United States.

We hope this blog helped you to know how to deal with your doctor who is stubbornly refusing to take Medicare.