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How to Find a Primary Care Doctor Who Accepts Medicare

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Almost everyone has to find a primary care doctor at some point. But when you add Medicare into the equation, does that make it more difficult? Learn how to find a primary care physician near you who accepts Medicare assignment.

Why would I need a primary care doctor near me who accepts Medicare assignment?

When you’re on Medicare and you visit a doctor’s office, Medicare typically covers its share of the visit if the doctor accepts Medicare assignment. Medicare may cover visits with doctors who don’t accept Medicare assignment, but usually you’ll have to pay a higher cost-sharing amount or you might have to pay the entire charge at the time of service.

Under Original Medicare (Part A and Part B), Medicare Part B usually covers 80% of primary care doctor visits, while you pay the other 20%, if the doctor accepts Medicare assignment.

Medicare assignment means that the doctor agrees to accept Medicare-approved amount as full payment for the visit and won’t charge the patient any more than the standard Part B copayment. Your Medicare Part B deductible may apply.

What happens if I see a primary care doctor who doesn’t accept Medicare assignment?

If you go to a primary care physician who doesn’t accept Medicare assignment, you might have to pay the full amount up front. The doctor’s office may reimburse you for the Medicare-covered amount later. The doctor is not allowed to charge you for filing a claim with Medicare – that’s the doctor’s responsibility.

There may be some cases when you have to file the claim, however.

A primary care doctor who doesn’t accept Medicare might be allowed to charge you up to 15% more than the Medicare-approved amount. This 15% “limiting charge” doesn’t apply to every Medicare service or supply.

How do I find a primary care doctor near me who accepts Medicare assignment?

Here are a few ways to find a primary care doctor near you who accepts Medicare.

  • If you already have a doctor, or you have a specific doctor in mind, call the doctor’s office and ask.
  • Enter your zip code on this page. Click “Add your doctors” and enter the name of a primary care doctor if you have one in mind.
  • You can contact one of eHealth’s licensed insurance agents, who will help you find a doctor who accepts Medicare assignment.
  • You can sign up for a Medicare Advantage plan. Many Medicare Advantage plans have provider networks who contract with the plan to provide Medicare services. These doctors accept Medicare assignment. The plan can help you find a primary care physician near you. If you sign up for a Medicare Advantage plan, you still need to pay your Medicare Part B premium, along with any premium the plan may charge.

Do you need some help finding a primary care doctor near you who takes Medicare? Contact us, and an eHealth licensed insurance agent can help you. To try out our “Add your doctors” tool, just enter your zip code on this page to get started.

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