My mom is on Medicare, can a doctor's office refuse to see a Medicare patient?

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When I first arrived in our new town, I set out to find Mom a doctor. I got good referrals. Every office I called said that they were not taking new patients. This week I needed to go to the doc and called one of those offices. Suddenly, they are taking new patients.
Can a doctor legally refuse to take Medicare patients? No one has come out and said this, so I'm not sure now.

Answers 1 to 10 of 68
I'm no expert but I think doctors can choose not to accept Medicare patients just as they can choose what insurances they wish to accept. It's sad but a lot of doctors do not feel they get enough reimbursement so they don't participate with Medicare.
Top Answer
Doctors can refuse patients based on the reimbursement including Medicare. Typically they just say that outright. More and more practices are being bought by hospitals, these docs will then take Medicare because they will feed into the hospital which almost always takes Medicare.
It is true that a Dr's office can refuse patients regardless of payer source. As patients switch payer sources, such as the various insurances that the Dr. is not a provider for they will get openings for new patients.
Doctors do not have to see Medicare patients, but it must be an overall policy. That means they can not see some Medicare patients and not others. If they see any Medicare patients, they must see all Medicare patients.

I would try looking for a geriatric specialist or may be a DO (doctor of osteopathy) as they are more likely to see Medicare patients.
I had the same problem. There was not a doctor in our town that accepted new patients on Medicare. We finally found one about 20 minutes away. I'm not sure I blame the docs though. The amount that they receive from Medicare is hardly worth their time. I do believe doctors have to continue to treat their current patients on Medicare, but they do not have to accept any new patients on Medicare ... it's their choice. I kinda liked the fact that I had to search long and hard to find a doc that accepted Medicare because when I finally did, he was so nice and patient with Mom. I think when money is not the only factor for a doc, they are usually so nice with the elderly ... at least that was my experience with her 2 doctors.
Yes MD's do not have to accept Medicare or any other health insurance. The reinbursement rate is so low that in many practices it costs them to have a Medicare patient especially an elderly one that take more time in both physician time as well as staff and having them in & out of the patient care room.

if she has a secondary insurer then often they will take Medicare patient. My mom has Medicare and has a federal Blue Cross and her eye & ortho doc's only would see her because they could bill BCBS.

Deb - the reason that hospitals take Medicare is because if they ever got built using federal funds, which until the last couple of decades that included almost ALL hospitals in the US, then they were built under the Hill Burton Act. Under Hill Burton the hospital was legally required to accept any and all federal health care programs and even more importantly they had to accept patients no matter what their ability to pay. When hospitals when thru the big building phases in the late 1970's and 1980's and were built new they could do a partial Hill Burton
by accepting Medicare and not the poverty ones. They would request a waiver from their regional planning body (the Heath System Agency in the region's Council of Government) because of whatever technology that was "special" they were doing - heart surgery was a biggie back then, then MRI buildings in the 80's.
No one back them ever though heath care would get so expensive in the US!

There are still hospitals out there under total Hill-Burton. You have to google to find out what might be in your area. But for the poor elderly and their caregivers, it is worth it. You cannot be billed if you have no ability to pay. Almost all are teaching hospitals too - which IMHO is the best place to go for care.


A long time ago doctors were willing to take livestock or your fruit/vegetables in exchange for medical care. Those days are long gone. Now its about cold hard cash. Medicare is famous for lots of red tape and a lengthy wait for payment. Doctors don't want to deal with all the crap, so they refuse patients with only medicare for insurance.

I once had a doctor tell me "it" wasn't going to work because I didn't care about my health. She grudginly took me on as a patient. I dumped her as a doctor immediately. Apparently, she only wanted healthy patients... not sick ones. Sick patients don't care about their health, but healthy patients do. What utter garbage! Worthless doctor. But, there are a slew of doctors that share that sentiment. They don't want difficult cases and the aging usually take more time and have more liability I suppose.

Its a show me the money world these days.
Just a little FYI............the amount a doctor receives for a Medicare patient is around $26. And that is for anything from a simple cold to running tests. And in their private practice they can refuse or accept anyone they choose....after all, it is their business.
Sure. I doctor may refuse to see a Medicare patient. If you are on Medicare, and you wish to see this particular physician, ask him (or the office) what would be the fee if you paid privately?.....out of pocket. Don't be surprised if the fee is outrageous.
We are in a transition phase as the massive Medicare cuts mandated by Obamacare kick in. It no longer makes economic sense to see these patients. The doctors are preparing for a future without Medicare by gradually getting rid of these patients.

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