When choosing a Medicare plan, one important factor to consider is finding doctors who accepts Medicare near you. No matter if you are looking for a clinic, hospital, new doctor, or if you just want to keep the doctor you’ve been seeing, finding out who takes Medicare is important. It all comes down to doing a little research before you schedule your next appointment and asking the right questions at your next visit.
Keep reading to learn more about finding a doctor that accepts Medicare near you and why it matters.
Of course, you can see a doctor who does not accept Medicare, but you may be charged a higher rate for your visit and any services you receive. This means your healthcare may be considerably more expensive.
By choosing a doctor that accepts Medicare, you’ll ensure you are charged the negotiated and acceptable rate. Your doctor’s office will also bill Medicare for your visit. In most cases, a doctor that accepts Medicare will also wait to hear back from Medicare before asking you to pay any cost difference if appropriate.
There are a few simple ways to find a doctor who accepts your Medicare plan:
- Visit Physician Compare: The Centers for Medicare & Medicaid Services (CMS) has a tool that allows you to look up doctors near you and compare them side-by-side.
- Check the Medicare website: The official Medicare website has many resources for finding providers and facilities that accept Medicare near you. For example, you can find and compare hospitals or other providers and search what services are covered by your Medicare plan.
- Check your insurance company provider listings: Medigap and Medicare Advantage are Medicare plans provided through private insurance companies. To find doctors that accept these forms of coverage, you’ll need to check with your selected provider for a listing.
- Check your network: If your Medicare coverage is provided through an insurance provider with a network of doctors and hospitals, check with the company to be sure your doctor is in their network This can be done by calling your insurance provider or checking their website.
- Ask trusted friends and family members: If you have any friends or family members who also use Medicare, ask them about their healthcare providers. How attentive is the doctor? Does the office handle their requests promptly and with ease? Do they have convenient hours?
A Primary Care Physician (PCP) is the doctor you see regularly. Your PCP generally provides the very first level of care you receive, such as check-ups, non-emergency appointments, and routine or annual exams.
Many people prefer to have a dedicated PCP so that they always know who they’re seeing for their appointment. Having a doctor who already knows your history and health goals can make appointments feel more effective and fruitful while eliminating anxiety around surprises.
Some private insurance companies may require customers to have one PCP who must approve and make referrals to other specialists or diagnostic procedures and tests.
Not every Medicare plan requires you to choose a primary care physician. If you’d rather not limit yourself to one office and one doctor, then you can continue to see other doctors who accept Medicare.
However, if you join a Medicare HMO through a Medigap or Medicare Advantage plan, you may need to choose a PCP. This is because your PCP may be responsible for referring you to a specialist for care through your HMO.
For most people, having a doctor they trust who is located conveniently is an important part of their healthcare. While it is an extra step, it’s important to verify that your doctor accepts Medicare coverage to ensure you get the most from your Medicare benefits.