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Do Most Medical Providers Accept Medicare?


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It can be stressful if you need to find a Medicare provider – that is, a provider who accepts Medicare payment. But we might have some good news for you. Here are some facts about Medicare providers and how to find one.

How many Medicare providers are there?

Medicare providers– may be in greater supply than some people realize. More than 9 out of 10 primary care doctors (93%) accept Medicare, the Kaiser Family Foundation (KFF) reported in 2015.

There are about 480,000 primary care doctors in the United States, notes a KFF report in 2019. So, if 93% of doctors accept Medicare patients, that’s about 446,400 Medicare providers in the country.

Medicare assignment is an agreement with Medicare to accept the Medicare-approved amount as full payment for a health-care service. A provider who takes Medicare assignment can’t bill you for more than the Medicare-approved amount, but can charge you the standard Medicare deductible and/or coinsurance or copayment amount.

You can also get care from Medicare providers who don’t accept assignment, but are willing to accept Medicare payment in part or for some services.

Are most providers accepting new Medicare patients?

According to the KFF report, about 72% of Medicare providers are accepting new Medicare patients. By contrast, about 80% of all primary care physicians accept new privately insured patients.

Some interesting facts from the Kaiser Family Foundation research:

  • Among Medicare providers, about a third of them report that more than half their patients are enrolled in Medicare.
  • Younger Medicare providers (under age 55) take a higher percentage of new Medicare patients than their older counterparts. KFF says that may be because younger doctors are trying to build their caseloads, which may be the opposite of what older doctors are doing.
  • African-American, Hispanic, and Asian doctors generally accept Medicare patients at a higher rate than white doctors. That acceptance rate is 86% for African American doctors; 83% for Asian doctors; and 66% for white doctors. (The African American group also includes those who self-identify as Hispanic or another race.)

How can you find a Medicare provider where you live?

Since most medical providers accept Medicare assignment, and new Medicare patients, in most cases it shouldn’t be too hard to find a Medicare provider in your area.

One way to find out if a health-care provider takes Medicare assignment is to call the doctor’s office and ask. You can also reach out to eHealth’s licensed insurance agents, who can help you find a Medicare provider.

Here’s another easy way to find a Medicare provider. If you sign up for a Medicare Advantage plan that has a provider network, you can generally expect the providers in that network to accept Medicare assignment. Not every Medicare Advantage plan has a provider network, but many of them do. Read about the different kinds of Medicare Advantage plans.

Want to see what Medicare Advantage plans are available where you live? You can begin comparing plans right away – just enter your zip code on this page. And remember, you’re welcome to contact an eHealth licensed insurance agent.

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