How Do I Find a Medicare Provider I Like?
Your health-care providers play a key role in your well-being, so it’s important to choose a Medicare provider that is right for you.
What should I consider when looking for a Medicare provider?
How you find a Medicare provider you like generally depends on three factors:
- How you receive (or intend to receive) your Medicare benefits
- What type of Medicare providers you want
- Whether you have an existing relationship with a Medicare provider
Find Medicare providers through a Medicare Advantage plan
You have a choice in how you receive your Medicare benefits, in most cases. You can receive Medicare Part A (hospital insurance) and Part B (medical insurance) from the government-administered Medicare program, called Original Medicare. Medicare providers are hospitals, doctors, and other health-care professionals who agree to accept Medicare’s approved amounts as full payments for covered services and medical supplies.
Non-participating providers haven’t signed an agreement to accept assignment for all Medicare-covered services, but they can still choose to accept assignment for individual services.
Under Original Medicare, you’re typically covered if you use Medicare providers who accept Medicare payment, called “assignment”. You may still have to pay deductibles and coinsurance or copayments.
You may decide that a Medicare Advantage plan is right for you. Under the Medicare Advantage program, you get your Medicare Part A and Part B benefits through a private, Medicare-approved insurance company. In this case, you may need to select Medicare providers who participate in the plan’s network to receive the full benefits of the plan and minimize your out-of-pocket expenses.
If you decide to enroll in a Medicare Advantage plan, you still need to pay your monthly Medicare Part B premium, and any premium the plan charges.
Find Medicare providers by type
You may know the type of Medicare provider you seek – for example, a primary care physician, a podiatrist, or an oncologist. If you’re not sure, it may be helpful to think about Medicare provider types in relation to Medicare covered services. For instance, hospitals and skilled nursing or rehabilitation facilities provide most of the services covered by Medicare Part A. Medical and behavioral health doctors, medical equipment suppliers, outpatient diagnostic lab, radiology, and surgical centers provide most of the covered Medicare Part B services.
Some Medicare health plans have search tools on their websites to help you find doctors by type. eHealth has a tool that lets you enter a doctor’s name, and displays any Medicare health plans that may have that doctor in their network.
Find Medicare providers that meet your needs
Maybe you already have established good relationships with your doctors and a preference for certain local hospitals, health-care centers, or medical suppliers. In this case, usually all you need to do is verify they are Medicare providers who accept Medicare assignment, or that they’re part of the network of the Medicare plan you select.
Tools to help you find Medicare providers you like
If you decide to enroll in a Medicare Advantage plan, you can find Medicare providers in the plan’s network using the eHealth online search tool.
- Simply enter your zip code and click the Browse Plans button.
- Next, select the Find Doctors tab. You can add up to 3 doctors’ names. The search tool will report whether your doctors are participating in the Medicare Advantage plans’ networks.
You may also verify this information by contacting any eHealth licensed insurance agent, who will be happy to help you.
If you don’t have a doctor, you can get help selecting an in-network Medicare provider by reviewing the Medicare Advantage plan’s provider directory on its website or speaking with a customer service representative. To identify Medicare providers who you like, you may want to verify the practitioner can meet your preferences, such as
- Convenient location and office hours
- Acceptance of new patients and the wait time for appointments
- Ability to communicate in your preferred language (if English is not your primary language)
- Board certification status and medical experience
- Hospital(s) the doctor uses for hospitalizations and outpatient services
Finally, you may want to supplement your Medicare provider search with recommendations from family or friends. It is also a good idea to schedule a visit with a new Medicare provider to determine if you are comfortable in the setting and confident you can establish a meaningful rapport with the Medicare provider.
Remember, you can get a lot of information just by entering your zip code on this page and following the prompts. Don’t forget the Add Your Doctors tool. And eHealth licensed insurance agents are ready to help you if you reach out to us.