How Do I Find Medicare Doctors Near Me?

Finding doctors that accept Medicare is important for any senior looking to maintain their healthcare costs. Fortunately, 98% of physicians accept Medicare in the United States. A common search among seniors looking for healthcare online is for Medicare doctors near me. Because there are so many doctors who accept Medicare, it’s easy to find one for most seniors in their area.

Do All Doctors Accept Medicare?

No, not all doctors near you accept Medicare. However, an overwhelming number of them do. A large majority (98%) of adult primary care physicians accept Medicare, according to the Centers for Medicare & Medicaid Services.

If you’re new to Medicare or have recently made a change in your coverage, you might be looking for a new provider. Luckily, finding a doctor near you is easier when you understand how to ensure your coverage is accepted.

Networks for Original Medicare are similar to the networks you might be used to from years on a health plan through your employer or the ACA Marketplace in that to use your benefits, you’ll need to go to a facility enrolled in Medicare.

When you pair your Original Medicare with a Medicare Supplement (Medigap) plan, any practitioner who accepts Original Medicare must accept your Medigap coverage for the balance. Although Medigap policies are available through private insurance companies, they do not come with specific network restrictions. Thus, your practitioner cannot refuse your Medigap plan as secondary payment if they take Original Medicare primarily.

But there is a notable difference with your Medicare coverage. There are more doctors within a Medicare network than there are in an employer or ACA insurance network. This means seniors can enjoy a wider range of healthcare and are likely to be afforded better options.

Additionally, for seniors enrolling in Medicare Advantage, there is another key difference. You can go to doctors outside of your plan, depending on which Medicare Advantage plan covers you.

What Doctors Can You See with Medicare?

Original Medicare (Medicare Part A and Part B) does not restrict you to a network of doctors. You can visit any physician who accepts Medicare.

But, you may save money if you make sure first that providers accept Medicare Assignment. The easiest way how to find a Medicare doctor near you is to use the Physician Search tool on Medicare.gov.

To use the tool, input your location and whether you are searching for a primary care physician or a specialist. Then press the search button.
You will see a list of doctors in your area who accept Medicare.

The next step is to call the office and determine if they are accepting new patients.

You can also use the Care Compare tool to find and compare doctors, clinicians, and hospitals near you. This tool includes listings for skilled nursing facilities, hospice care, rehabs, dialysis facilities, and more.

Additionally, when searching for doctors near you that accept Medicare, here are other methods you may wish to consider:

• Contact your insurance provider to determine whether your doctor is in your network.
• Check the listings of your insurance provider to see which doctors accept your coverage. This can be an important option for seniors with Medicare Advantage plans.

Do All Doctors Accept Medicare Advantage?

Unlike Original Medicare or Medigap plans, Medicare Advantage plans come with provider networks. You’ll want to make sure that all your doctors are in the plan’s network when using Medicare Advantage. Otherwise, you’ll be paying out-of-pocket.

There are different types of Medicare Advantage plans. To understand whether or not your doctor is in your network, seniors must refer to the details of their individual plans as networks may vary.

Some specialty doctors are covered by Original Medicare, including Language Pathologists, Mental Health Therapists, Physical Therapists, and Podiatrists. But for seniors covered by a Medicare Advantage plan, a referral may be necessary to receive healthcare from a specialist that is covered.

Overall, the healthcare needs of each senior will vary, meaning the best solution for your coverage will also vary. It’s important for seniors to speak with a licensed Medicare agent to pinpoint the best options for their healthcare.

Considerations When Searching for Doctors Near You Accepting Medicare

Having a Medicare doctor near you is important for receiving the best healthcare, but there are many other considerations seniors will want to remember. Sure, having a physician in your network will help you save money, but healthcare is more complicated than this.

You will want to be sure that the Medicare doctor near your home is also familiar with your healthcare needs, especially if you are dealing with a rare condition.

Seniors that are looking for doctors who not only accept Medicare coverage but are also specialists or board-certified in a specific area may also do so through the many tools available.

The American Medical Association (AMA) has a search engine online specializing in helping find Medicare doctors near you. Seniors can search by specialty and review their board certification and training.

As a nonprofit organization, the American Board of Medical Specialties (ABMS) comprises 24 medical specialty boards responsible for overseeing certification for doctors. Here, you can look up your doctor to find their credentials.

You can also use the tool to find board-certified doctors in a certain specialty near you. While you will need to sign up, this tool is free. Seniors can also find a book that lists doctors from ABMS, known as The Official ABMS Directory of Board-Certified Medical Specialists. This publication is often found at Area Agencies on Aging, Social Security offices, senior centers, libraries, and hospitals.

The Administrators in Medicine (AIM) provides a search tool online for seniors. You can look up doctors by name to view their licensing background and any if any, disciplinary actions taken against them in the past. AIM consists of state medical board directors.

Finally, seniors can take advantage of the search directory provided online by the National Library of Medicine to research their primary physicians.

How Do I Change My Primary Doctor With Medicare?

Seniors enrolled in Medicare Advantage plans must choose a primary care doctor. Original Medicare does not have this requirement. If you would like to switch your primary doctor, you’ll need to fill out a request of change form online through your insurance provider or by calling member services.

Because your primary care doctor is the one that makes referrals for specialty care, this is an important consideration for seniors. While you may still be able to receive treatment without a referral, the costs are often not covered by your insurance provider, meaning you’ll be responsible for expensive out-of-pocket costs.

How to Get Additional Coverage for Medicare Doctors Near You

Even when your doctor accepts it, Original Medicare doesn't pay for everything. But when combined with a Medigap policy, you can get complete coverage at most of the healthcare providers in the United States.

If you’re searching for “Medicare doctors near me,” you’re likely a senior that can use the right benefits while managing your healthcare costs. Call us at the number above to speak with one of our agents to help find the right benefits for your needs. You can also fill out our compare rates form, and we'll prepare a comparison of premiums for top-rated plans in your area.

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