No, not all doctors accept Medicare. The ones who accept Medicare’s amount as full payment are called participating providers. If you see a doctor who does not accept Medicare, you may have to pay an extra 15% for covered services.
Doctors and Medicare Assignment
Doctors who accept Medicare assignment agree to take the Medicare-approved amount for covered services as full payment for your treatment. These are participating providers.
If your doctor accepts Medicare assignment, they will work with your Medicare Supplement as well. Medicare Supplement policies help to reduce your out-of-pocket spending toward Part A and Part B services by helping pay for your copayments, coinsurance, some deductibles, and more. Doctors who accept Medicare assignment will respect this coverage.
Doctors who accept Medicare will not necessarily accept your Medicare Advantage coverage. Those plans usually work with a network of providers contracted to bring you lower rates. If you want a Medicare Advantage plan and wish to keep your provider, make sure they are covered under the plan.
Check with your doctor to see if they can write Medicare Part D prescriptions. You should be covered for prescriptions written by a doctor who accepts Medicare.
Doctors Who Do Not Accept Medicare
Doctors do not have to accept Medicare. Doctors who do not accept assignment may ask for immediate payment for your services. They can also charge up to an additional 15% above the Medicare-approved amount for the covered services on top of your copayment. This added cost is referred to as a Part B excess charge.
A few Medicare Supplement policies cover Part B excess charges. This can help you avoid that extra 15% for your care.
When you see a doctor who does not accept Medicare, you will need to sign a contract to assume responsibility for paying the full cost of the covered services.
For services not covered by Medicare, there is no need to sign a contract, and you will need to pay the full cost for those services.
Finding a Medicare Doctor
If you are not sure whether your doctor accepts Medicare, ask. In the hospital, it is important to know which providers are covered, so be certain to check the status of the people treating you in that setting to avoid unexpected excess charges.
A majority of doctors accept Medicare patients. When looking for a provider, seek someone who is accepting new Medicare patients, as not all providers will take on new patients.
Magellan Healthcare can help you compare Medicare plans to find coverage with the providers you like. Speak with our team for assistance in finding your next Medicare plan.
