Can My Doctor Refuse To Accept Medicare Coverage?





Many citizens want to know, can my doctor refuse to accept Medicare coverage? Unfortunately, patients seeking medical care may find that more and more doctors are refusing to accept Medicare coverage. Since it is not discrimination and doctors have the right to choose which providers they will and will not accept, they have the legal right to refuse Medicare coverage at their office.

How Can I Find Out if My Doctor Accepts Medicare Coverage?

The easiest way to find out if your doctor accepts Medicare is to call the doctors office and see if they will accept it. Sometimes, depending on the situation, the doctors office may make an exception or help work out another means of payment if you are not able to make the full payment with out Medicare. Keep in mind that most Specialists will not accept Medicare coverage due to low reimbursement offered by Medicare.

Can Doctors Refuse to Accept My Medicare Coverage at the Emergency Room?

When you have an emergency, doctors can not refuse to see you just because you have Medicare coverage. They may refuse to accept Medicare but, they can not refuse to see you. However, most hospitals do accept Medicare along with many other providers. In most situations, if they don’t accept Medicare they will bill you for any expenses incurred.

If for some reason, an emergency care facility refuses treat you because they do not accept Medicare, be sure to follow up with your local governmental agencies and health board to report the conduct.

How Can I Find A Doctor That Will Accept Medicare Coverage?

The easiest way to find a doctor that accepts Medicare Coverage is to create a list of doctors that you are interested in seeing. Then call each doctor and see what form of Medicare Coverage they will accept, if any. During that time you can discuss payment options for any treatment they refuse to cover, ask questions about billing, and set up appointments.



10 Responses to “Can My Doctor Refuse To Accept Medicare Coverage?”

  1. I am a Federal Retiree and will be applying for Medicare. I currently have Blue Cross/Blue Shield under the federal plan as my primary insurance. At age 65, when Medicare becomes my primary insurance and my doctor no longer accepts Medicare, will my Blue Cross /Blue Shield continue to accept his fees as the primary insurance even if Medicare would be primary after age 65? Thanks.

  2. margie says:

    From what I know as an RN Medicare is always the primary insurance.I do not think bc/bs will accept teh fees as primary insurance. Plus many drs will not take medicare if it is the primary insurance

  3. Doris Krupp says:

    If a non participating doctor sees you for emergent care they must bill medicare first. They cannot bill you prior to submitting a claim to Medicare. To do otherwise is considered insurance fraud.

  4. Ed Buck says:

    Every American citizen over the age of 65 should press their congressmen or state legislatures to compel any doctor who received any government assistance or government loan in their education or career to accept any senior citizen who is covered by Medicare.

  5. bill evans says:

    Well stated.

  6. evan white says:

    “From what I know as an RN Medicare is always the primary insurance.I do not think bc/bs will accept teh fees as primary insurance. …”

    No, Medicare is not primary is the company carrying BC/BS has more than 50 employees. BC/BS is primary then. Medicare is secondary.

  7. evan white says:

    Typo:
    “From what I know as an RN Medicare is always the primary insurance.I do not think bc/bs will accept teh fees as primary insurance. …”

    No, Medicare is not primary IF the company carrying BC/BS has more than 50 employees. BC/BS is primary then. Medicare is secondary.

  8. Hey, beautiful blog but there is a issue whereby on occassion I am redirected to the base page when I view other topics within your web page.

  9. Family history is heavy with cancer. I amlooking for a dr.and a hospital that will accept Medicare and medi cal with supplemental insurance oh Anthem Blue cross to have a colon ops hay. Am having trouble with hospitals saying that they do not accept third insurance. So how does one get test done that are needed? I live in Fresno County, California. Thank you for any assistance you can offer me.
    Gratefully,
    Joan Schaller

  10. roger says:

    I have medicare as well as a group plan from federal retirement with BC/BS. If my Family Dr. who is on the preferred provider list stops accepting medicare, will BC/BS cover as before or will I have to look for another Dr. or make up the difference out of pocket?

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