Medicare is not accepted everywhere. The vast majority of hospitals and doctors do participate in the program, but a meaningful number of physicians don’t take new Medicare patients, some charge above Medicare rates, and a smaller group has opted out of Medicare entirely. Your experience also depends on whether you have Original Medicare or a Medicare Advantage plan, and where in the world you need care.
How Many Doctors and Hospitals Accept Medicare
Hospital acceptance is nearly universal. According to American Hospital Association data from 2024, 96% of U.S. community hospitals get at least half their patient volume from Medicare and Medicaid combined. It’s rare to find a hospital that won’t take your Medicare coverage.
Physician acceptance is high but not quite as broad. About 72% of primary care doctors accept new Medicare patients, compared to 80% who accept new privately insured patients. Specialists generally accept Medicare at somewhat higher rates than primary care doctors. The gap between Medicare and private insurance acceptance exists largely because Medicare reimburses at lower rates, and those rates have been declining. For 2025, Medicare’s average physician payment dropped by about 2.9% compared to the previous year.
Roughly 55,000 providers have formally opted out of Medicare altogether. That’s a small fraction of the more than one million doctors in the U.S., but if your preferred physician is among them, it matters a great deal to your wallet.
Three Ways Doctors Relate to Medicare
Not all doctors who “accept Medicare” treat it the same way. There are three distinct categories, and the differences affect what you pay.
Participating providers accept the Medicare-approved amount as full payment. You pay only your deductible and coinsurance. The doctor bills Medicare directly and typically waits for Medicare to pay before collecting your share. This is the lowest-cost scenario for you.
Non-participating providers are still enrolled in Medicare but don’t agree to accept the Medicare-approved amount every time. They can charge up to 15% above the Medicare-approved rate for a given service. This extra amount is called the limiting charge. You may also need to pay the full bill at the time of your visit and wait for Medicare reimbursement. These doctors are still required to submit claims to Medicare on your behalf.
Opted-out providers have left the Medicare system entirely. Medicare will not pay for any services you receive from these doctors, except in emergencies. If you see an opted-out provider, you’ll sign a private contract and pay entirely out of pocket. No part of that bill can be submitted to Medicare for reimbursement.
Original Medicare vs. Medicare Advantage Networks
The type of Medicare plan you have changes the answer to “where can I go?” significantly.
With Original Medicare (Parts A and B), you can see any doctor or visit any hospital that accepts Medicare, anywhere in the United States. There’s no network, no referral requirement for specialists, and no need to stay in a particular geographic region. If a provider participates in Medicare, you’re covered.
Medicare Advantage plans (Part C) work more like private insurance. Most are HMO or PPO plans with defined networks. You typically need to use doctors and facilities within your plan’s network and service area for non-emergency care. Some PPO-style plans offer out-of-network coverage, but at a higher cost. Many HMO plans also require a referral from your primary care doctor before you can see a specialist. So even if a doctor accepts Medicare in general, they may not be in your specific Medicare Advantage plan’s network.
This distinction catches people off guard. A doctor who participates in Original Medicare might not have a contract with your Medicare Advantage insurer. Always verify with both the provider’s office and your plan before scheduling.
Where Medicare Works Geographically
Medicare covers care in all 50 states, Washington D.C., Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. Anywhere outside those areas is considered international, and Medicare generally does not cover you abroad.
There are three narrow exceptions for foreign hospital care. Medicare may pay if you’re in the U.S. when an emergency occurs and a foreign hospital is closer than the nearest U.S. hospital that can handle it. It may also pay if you’re traveling through Canada on the most direct route between Alaska and another state and have a medical emergency. And if you live near the border and a foreign hospital is simply closer to your home than any U.S. hospital equipped to treat your condition, Medicare can cover care there regardless of whether it’s an emergency.
Outside those situations, if you travel internationally, you’ll need separate travel health insurance. Some Medicare Supplement (Medigap) plans include limited foreign travel emergency coverage, but Original Medicare and most Medicare Advantage plans do not.
Concierge Medicine and Medicare
Concierge or “direct primary care” practices charge an annual or monthly membership fee for enhanced access, longer appointments, or other perks. Some of these doctors still participate in Medicare, and some don’t.
If a concierge doctor accepts Medicare assignment, they cannot charge your membership fee for services Medicare already covers. The fee can only pay for extras that fall outside Medicare’s benefits. If a concierge doctor doesn’t accept assignment, they can charge up to 15% above the Medicare-approved amount for covered services. And if they’ve opted out entirely, you’ll pay for everything through your private contract.
Before joining a concierge practice, ask specifically whether the doctor bills Medicare for covered services or whether your membership fee is meant to replace Medicare billing altogether.
How to Check if a Provider Accepts Medicare
The most reliable way to verify is Medicare’s own compare tool at Medicare.gov. You can search for doctors and clinicians enrolled in Medicare, see their specialties, check whether they offer telehealth, and view their facility affiliations with hospitals, skilled nursing facilities, home health agencies, and other care settings. The tool also shows procedure volume data for common surgeries like hip and knee replacements, cataract surgery, and colonoscopies.
What the tool won’t always clarify is whether a provider is participating (accepting assignment) or non-participating. For that, call the provider’s billing office directly and ask two questions: “Do you accept Medicare?” and “Do you accept Medicare assignment?” The first tells you whether they’ll bill Medicare at all. The second tells you whether they accept the Medicare-approved amount as full payment or whether you could face that extra 15% limiting charge.
If you have a Medicare Advantage plan, start with your plan’s provider directory rather than Medicare.gov. Your insurer’s network is what determines your coverage, not Medicare’s general enrollment list.