Skip to main content
Medicare AdvantageMedicare CoverageMedicare Insurability RulesOriginal Medicare

Do you know if your doctors accept Medicare?

When it comes to making your Medicare decision, one of the hardest parts is deciding whether to choose Original Medicare or Medicare Advantage.

To decide which program fits you best, it will depend on the doctors you want to see. 

As a reminder, with Original Medicare, you can get care from any doctor or hospital that accepts Original Medicare. While with Medicare Advantage, you can usually only see doctors in their network.

This is why I always recommend you begin your Medicare process by making a list of these two things:

  1. All the doctors that you currently see.
  2. The doctors you want to see once you’re on Medicare.

Once you’ve made your list, contact those doctors’ offices and ask them two questions:

1. What types of Medicare do you accept?

Your doctor may not know, but someone at their office will, whether that’s a nurse, receptionist, or someone in billing. The critical factor of this question is to know if your doctor accepts:

  • Original Medicare
  • Medicare Advantage (and if so, what type)
  • No Medicare at all

2. Do you have any Medicare-specific rules?

One of the most common rules doctors have is the number of Medicare patients they treat. Once they hit that number, they won’t see any new Medicare patients.

While many doctors don’t have limits, it’s critical to know if your doctors have any unique Medicare rules.

Once you have the answers to these questions, you can then look at what Medicare program would fit you best.
Unfortunately, not checking with their doctors is where people make their first mistake and regret their Medicare decision.
Here is the thing, it is very common for an insurance company to approach you with a Medicare Advantage plan first. They do this because Advantage plans make them the most money (which insurance companies share in their financial reports). Since it makes them the most money, they will do everything they can to sell Medicare Advantage before any other product.
Insurance companies also put other perks in the Medicare Advantage plans like vision, dental, and silver sneakers to make them even more appealing.
Let me repeat this because it’s important, insurance companies are incentivized to sell you Medicare Advantage plans, so they tell you about all the perks. Most importantly, they rarely, if ever, tell you about the doctors you can or cannot see on Medicare Advantage plans.
As I said above, with Medicare Advantage plans, you can usually only see the doctors in their network.
This is why it is so critical that you ask your doctors what Medicare plans they do and do not accept. Medicare has strict rules that can make it hard, if not impossible, to switch Medicare programs in the future.
So please ensure you understand the Medicare program and plan you pick before you finalize your decision. You may not get a second chance.

To easily make the right Medicare decision you can CLICK HERE to sign up for our Medicare Enrollment Concierge.

Eliminate the Medicare confusion blues

Medicare has neither endorsed nor reviewed the information provided by the Medicare Coach or this website. Medicare Coach, LLC ® is not connected with or endorsed by the United States government or the Medicare program.