Finding a Medicare doctor who accepts assignment is one of the most direct ways to reduce what you pay out of pocket for medical care. A doctor who accepts assignment agrees to take Medicare's approved amount as full payment, so you only owe your standard 20% coinsurance plus any applicable deductible. Doctors who do not accept assignment can charge up to 15% more on top of the Medicare-approved amount, which can add up quickly over the course of a year.
This guide explains what Medicare assignment means, the three types of providers you will encounter, and the exact steps to find participating doctors in your area using Medicare's official tools.
What Medicare Assignment Actually Means
When a doctor "accepts assignment," they agree to accept the Medicare-approved payment rate as full payment for a covered service. Medicare pays 80% of that approved amount, and you pay the remaining 20% (your Part B coinsurance), plus your Part B deductible if it has not been met.
When a doctor does not accept assignment on a claim, they can charge more than the Medicare-approved amount. The maximum additional charge allowed is 15% above the Medicare-approved rate. That means instead of paying 20% coinsurance, you could pay up to 35% of the Medicare-approved amount out of pocket.
For example, if Medicare approves $200 for a service:
| Provider Type | Medicare Pays | You Pay |
|---|
| Participating (always accepts assignment) | $160 (80%) | $40 (20%) |
| Non-participating (takes assignment this visit) | $152 (80% of reduced rate) | $38 |
| Non-participating (does not take assignment) | $152 (80% of reduced rate) | $38 + up to $30 excess charge |
| Opt-out provider | $0 | Full cost |
The 15% excess charge rule is called the "limiting charge." Doctors cannot legally charge more than 15% above the Medicare-approved amount, but that still represents a meaningful cost increase for people on fixed incomes.
The Three Types of Medicare Providers
Understanding the three categories of Medicare providers helps you know what to expect before scheduling an appointment.
Participating Providers
Participating providers have signed an agreement with Medicare to always accept assignment on every Medicare claim they file. These doctors accept the Medicare-approved amount as full payment for all covered services. If you see a participating provider, your only out-of-pocket costs are your Part B deductible and your 20% coinsurance.
Participating providers are the most common type. Most primary care physicians and specialists who accept Medicare fall into this category.
Non-Participating Providers
Non-participating providers are enrolled in Medicare but have not signed a contract agreeing to always accept assignment. They can choose to accept assignment on a claim-by-claim basis. When they do not accept assignment, they can charge up to the limiting charge (15% above the Medicare-approved amount).
Non-participating providers also receive a slightly lower Medicare reimbursement rate -- 5% less than participating providers receive. Even when a non-participating provider accepts assignment on a specific claim, their reimbursement rate is lower than a participating provider's.
Opt-Out Providers
Opt-out providers have chosen not to participate in Medicare at all. They have signed an affidavit opting out of the program. If you see an opt-out provider, Medicare will not pay anything for the service (except in emergencies), and you are responsible for the full cost. You must sign a private contract with the provider agreeing to this arrangement before receiving non-emergency care.
Opt-out providers include some psychiatrists, psychologists, and certain specialists. Always confirm a provider's status before scheduling if you plan to use Medicare.
Step-by-Step: How to Find a Doctor Who Accepts Assignment
Step 1: Go to Medicare's Care Compare Tool
Visit medicare.gov/care-compare. This is Medicare's official provider search tool. It replaced the old Physician Compare website and includes doctors, clinicians, hospitals, home health agencies, and other provider types.
Step 2: Select "Doctors and Clinicians"
On the Care Compare homepage, select "Doctors and Clinicians" from the provider type menu. You can also search for group practices, which may be useful if you are looking for a specific medical practice rather than an individual physician.
Step 3: Enter Your Location
Enter your ZIP code, city, or state to find providers near you. You can also filter by distance (for example, within 5, 10, or 25 miles).
Step 4: Search by Name, Specialty, or Condition
You can search by:
- Provider name (if you have a specific doctor in mind)
- Medical specialty (such as cardiology, internal medicine, or family practice)
- Condition treated (such as diabetes or heart disease)
Step 5: Filter for Providers Who Accept Assignment
Once results appear, look for the filter option labeled "charges only the Medicare-approved amount (you pay less out-of-pocket)" or similar language. Checking this box limits your results to participating providers who always accept assignment.
On individual provider profiles, look for the dollar sign ($) icon accompanied by text indicating the provider "charges the Medicare-approved amount." This confirms the provider accepts Medicare assignment.
Step 6: Review the Provider's Profile
Each profile includes the provider's name, specialty, practice location, contact information, and quality ratings where available. Review the profile to confirm the provider is currently accepting new Medicare patients. Care Compare may note whether the provider is accepting new patients, but this information can change. Calling the office to confirm is always a good idea.
Step 7: Call to Confirm Before Your First Appointment
Even after finding a provider through Care Compare, call the office before scheduling. Ask:
- "Do you accept Medicare assignment?"
- "Are you currently accepting new Medicare patients?"
- "Do you accept my Medicare Advantage plan?" (if applicable -- Medicare Advantage networks are separate from Original Medicare participation)
Provider information on Care Compare may not always reflect real-time changes, so a quick phone call saves time.
Other Ways to Find Participating Medicare Providers
Call 1-800-MEDICARE
If you do not have internet access, call 1-800-633-4227 (1-800-MEDICARE). Representatives can help you find participating providers in your area and confirm whether a specific doctor accepts Medicare assignment. The line is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
Ask Your Current Doctor for a Referral
If your current doctor does not accept Medicare or is leaving Medicare, ask them to refer you to a colleague who does. Doctors in the same specialty network often know who in the area is accepting Medicare patients.
Contact Your State Health Insurance Assistance Program (SHIP)
Every state has a free SHIP office that provides one-on-one Medicare counseling. SHIP counselors can help you find participating providers, review your coverage options, and answer questions about Medicare costs. To find your local SHIP office, visit shiphelp.org or call 1-800-MEDICARE and ask to be connected.
Ask Your Medicare Advantage Plan
If you are enrolled in Medicare Advantage (Part C) instead of Original Medicare, the assignment rules work differently. Medicare Advantage plans have their own provider networks. Contact your plan directly or use your plan's online provider directory to find in-network doctors. Going out of network with a Medicare Advantage plan can result in higher costs or no coverage at all, depending on your plan type (HMO vs. PPO).
Medicare Assignment and Medicare Savings Programs
If you have limited income, you may qualify for a Medicare Savings Program (MSP) that helps pay Medicare premiums, deductibles, and coinsurance. Finding a doctor who accepts assignment becomes even more important if you have an MSP, because your cost sharing may be covered at zero or reduced cost when you stay with participating providers.
The four Medicare Savings Programs in 2026 are:
| Program | Who It Helps | Monthly Income Limit (Individual) | Monthly Income Limit (Couple) |
|---|
| QMB (Qualified Medicare Beneficiary) | Pays Part A and B premiums, deductibles, coinsurance, copays | $1,350 | $1,824 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Pays Part B premium only | $1,616 | $2,184 |
| QI (Qualifying Individual) | Pays Part B premium (limited slots) | $1,816 | $2,455 |
| QDWI (Qualified Disabled and Working Individuals) | Pays Part A premium for working disabled people | $4,945 | $6,659 |
Asset limits for 2026 are $9,950 for an individual and $14,910 for a couple in most states. Some states (Connecticut, Delaware, Louisiana, Maine, and Mississippi) have no asset limit. California has much higher asset limits at $130,000 for an individual.
QMB status provides the broadest protection. Medicare providers who accept assignment cannot charge QMB enrollees any cost sharing (no deductibles, coinsurance, or copays) for Medicare-covered services. If a doctor bills you for cost sharing when you have QMB, you have the right to dispute that charge.
If you think you might qualify for a Medicare Savings Program, use our free benefits screener to check your eligibility in minutes.
States with No Excess Charge Protections
Eight states and Washington D.C. do not allow non-participating providers to charge the 15% excess charge at all. In these states, all Medicare providers must accept assignment for any Medicare patient. Those states are:
- Connecticut
- Massachusetts
- Minnesota
- New York
- Ohio
- Pennsylvania
- Rhode Island
- Vermont
If you live in one of these states, the participating vs. non-participating distinction still matters for reimbursement rates, but you are protected from excess charges regardless of which Medicare-enrolled provider you see.
What to Do if Your Doctor Stops Accepting Medicare
Doctors can choose not to renew their Medicare participation agreements each year. The annual Medicare participation enrollment period typically runs from November through December, with changes taking effect January 1.
If your doctor notifies you they are leaving Medicare or no longer accepting assignment, you have a few options:
- Ask if they will accept assignment on a case-by-case basis. Non-participating providers can still choose to accept assignment on individual claims even if they have not signed a participation agreement.
- Use Care Compare or call 1-800-MEDICARE to find a new participating provider in the same specialty.
- If you have a Medicare Advantage plan, contact your plan to find an in-network provider.
- Contact your SHIP office for free help navigating the transition.
Frequently Asked Questions
What does it mean when a doctor accepts Medicare assignment?
Accepting assignment means the doctor agrees to take the Medicare-approved amount as full payment for a covered service. You pay 20% coinsurance plus your Part B deductible. The doctor cannot bill you for any additional amount beyond that.
What is the Medicare excess charge?
The excess charge is an additional fee that non-participating providers can charge above the Medicare-approved amount. The maximum allowed excess charge is 15% of the Medicare-approved amount. This means your total out-of-pocket cost for that service could be up to 35% of the Medicare-approved rate instead of 20%.
Can I use Care Compare to find Medicare Advantage doctors?
Care Compare shows providers based on their Original Medicare participation status. For Medicare Advantage, you need to use your specific plan's provider directory, since Medicare Advantage plans have their own networks separate from Original Medicare.
Do all participating doctors accept new Medicare patients?
No. A provider can accept Medicare assignment but still have a closed panel and not be accepting new patients. Always call the office to confirm they are taking new Medicare patients before scheduling an appointment.
Is there a difference between accepting Medicare and accepting Medicare assignment?
Yes. A doctor can be enrolled in Medicare (meaning they can bill Medicare) but still choose not to accept assignment on every claim. A participating provider both accepts Medicare AND agrees to always accept assignment. A non-participating provider accepts Medicare but may or may not accept assignment on individual claims.
What if I accidentally see a non-participating or opt-out provider?
If you see a non-participating provider who does not accept assignment on your claim, you will receive a higher bill. For opt-out providers, Medicare pays nothing (except in emergencies). Always confirm a provider's status before a non-emergency appointment. If you receive an unexpected bill, contact Medicare at 1-800-633-4227 to review your options.
Where can I check if I qualify for help paying Medicare costs?
If your income is limited, you may qualify for a Medicare Savings Program or Extra Help (for prescription drug costs). Use our free benefits screener to check your eligibility based on your income, household size, and state.
How often should I verify my doctor accepts Medicare assignment?
Verify at the start of each year or any time your doctor's practice changes ownership or billing arrangements. Provider participation status can change annually, so it is worth a quick call to confirm at the beginning of each year or before major procedures.
