Medicare Blog

how to find a doctor on medicare

by Arielle Ratke Published 2 years ago Updated 1 year ago
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To find a doctor that accepts Medicare payments, you may want to visit the Centers for Medicare and Medicaid Services' Physician Compare. You can search by entering a health care professional’s last name or group practice name, a medical specialty, a medical condition, a body part, or an organ system.

Full Answer

Where can I find a doctor that accepts Medicare and Medicaid?

Jun 01, 2021 · Medicare.gov makes it easy to find and compare nearby health care providers, like hospitals, home health agencies, doctors, nursing homes and other health care services that accept Medicare. All in one place on Medicare.gov, you can: See how patients rate their care experiences at the hospitals in your area.

What doctors accept Medicare?

To find a doctor that accepts Medicare payments, you may want to visit the Centers for Medicare and Medicaid Services' Physician Compare. You can search by entering a health care professional’s last name or group practice name, a medical specialty, a medical condition, a body part, or an organ system.

Can I go to any doctor with Medicare?

Find Healthcare Providers: Compare Care Near You | Medicare. Find & compare nursing homes, hospitals & other providers near you. Learn more about the types of providers listed here. What's New? Click to begin searching for doctors & clinicians Click to begin searching for hospitals Click to begin searching for nursing homes Click to begin ...

Do all doctors accept Medicare?

If you’re not already logged into your Medicare account, a window will pop up for you to log into (or create) your secure Medicare account. Once you’re logged in, the provider will either automatically add to your favorites, or, if you’re adding a favorite doctor or clinician, you can select the box to make this provider your primary clinician, select the location you use, and …

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How to add a doctor to a list?

In a few easy steps you will: 1 Type your doctor’s last name in. 2 Find and select your doctor from the list of names that generates. Then, hit Continue. 3 Choose the address of the office location you use, or one nearby. 4 Choose the “Select” option to add that doctor to your custom list.

Do all doctors accept Medicare?

Many doctors accept Medicare’s nationwide network, but if you have a Medicare health plan, then a local network typically applies. In other words, not all Medicare doctors accept all Medicare health plans. Although a doctor or staff may check benefits or file claims, you as the patient must verify coverage before getting health services.

Finding an in-network provider can be easy

Simply select which type of provider you need (e.g., general practice, internist, dermatologist, etc.) and your coverage network type and enter your ZIP code. Now you’ll see a list of the in-network providers in your area along with their contact information.

Staying in network may save you money

Receive the care you need while potentially saving money on your medical costs. Some out-of-network deductibles may be twice as high as in-network deductibles, so it’s important that you choose an in-network doctor whenever possible.

You may save money by staying in network

Our doctor finder tool can help you locate a medical, dental or vision provider in your area who is part of Humana’s provider network.

What is primary care physician?

A primary care physician is the medical professional who generally oversees your health care, wellness visits, and preventive care. If you get sick, you generally see your primary care physician first. If you need specialist care, your primary care doctor may refer you to the specialist.

What is Medicare Advantage?

Medicare Advantage is another way to receive your Original Medicare benefits through a private insurance company. Medicare Advantage plans must cover everything that Original Medicare covers, except of hospice care, which is still covered by Medicare Part A.

What is a PCP?

According to the U.S. National Library of Medicine, a primary care provider (PCP) could be: 1 A generalist doctor who specializes in internal medicine or family practice 2 Nurse practitioners with training in adult care or geriatrics 3 Other practitioners

What is a PCP in medical terms?

National Library of Medicine, a primary care provider (PCP) could be: A generalist doctor who specializes in internal medicine or family practice. Nurse practitioners with training in adult care or geriatrics. Other practitioners.

Do you need a referral for Medicare Advantage?

Many Medicare Advantage HMO plans require a referral from your primary provider before they pay for tests or specialist care, even from providers within the plan network. If your plan requires a primary care referral and you don’t get one, the plan may not pay, even if the specialist service would otherwise be covered.

What is included in a medical emergency list?

The list usually includes not only primary care doctors, but also specialists, hospitals, pharmacies, and outpatient facilities contracted with the plan. Of course, if you have a medical emergency, you should get care from the closest appropriate provider, regardless of network.

Does Medicare cover doctor visits?

Medicare generally covers doctor visits in most medical settings, such as in the doctor’s office, in the hospital or outpatient department, in a nursing facility, or at an approved health clinic. If you enroll in a Medicare Advantage plan, you may need to select a primary care physician.

How to find a doctor who accepts Medicare?

There are a few simple ways to find a doctor who accepts your Medicare plan: 1 Visit physician compare. The Centers for Medicare & Medicaid Services (CMS) has a tool that allows you to look up doctors near you and compare them side-by-side. 2 Check the Medicare website. The official Medicare website has many resources for finding providers and facilities that accept Medicare near you. For example, you can find and compare hospitals or other providers and search what services are covered by your Medicare plan. 3 Check your insurance company provider listings. Medigap and Medicare Advantage are Medicare plans provided through private insurance companies. To find doctors that accept these forms of coverage, you’ll need to check with your selected provider for a listing. 4 Check your network. If your Medicare coverage is provided through an insurance provider with a network of doctors and hospitals, check with the company to be sure your doctor is in their network This can be done by calling your insurance provider or checking their website. 5 Ask trusted friends and family members. If you have any friends or family members who also use Medicare, ask them about their healthcare providers. How attentive is the doctor? Does the office handle their requests promptly and with ease? Do they have convenient hours?

Why is it important to verify that your doctor accepts Medicare?

The takeaway. For most people, having a doctor they trust who is located conveniently is an important part of their healthcare. While it is an extra step, it’s important to verify that your doctor accepts Medicare coverage or is in your Part C network to ensure you get the most from your Medicare benefits.

What is Medicare Advantage?

Medigap and Medicare Advantage are Medicare plans provided through private insurance companies. To find doctors that accept these forms of coverage, you’ll need to check with your selected provider for a listing. Check your network. If your Medicare coverage is provided through an insurance provider with a network of doctors and hospitals, ...

What is an HMO plan?

If you buy a type of Medicare Advantage plan called a Health Maintenance Organization (HMO), you’ll be given a list of in-network providers to choose from. If you decide to select a provider who is out of network, you may owe a higher cost or the full out-of-pocket amount for those services.

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