New Medicare Enrollment: How Do I Find A Participating Doctor?
When you turn 65, you may get Medicare automatically if you are receiving Social Security benefits, or you may need to enroll. You have choices as to how you get your coverage, including Original Medicare or one of the Medicare Advantage Plans, which are offered by Medicare-approved private companies that are required to follow the rules established by Medicare. No matter which option you choose, you will need information about participating providers. You can find information about physicians on medicare.gov.
How To Search for a Doctor on the Medicare Website
Medicare.gov gives you a variety of options for finding a doctor. You can find your current doctor or another medical professional by searching the government Medicare website with the following information:
Group or practice
Your other options include:
Browsing by specialty from A to Z: For example, if you need to see a doctor for your allergies, you can enter your city and state or zip code and click on “Allergy/Immunology.” The system will pull up a list of allergy specialists in your area that accept Medicare-approved payment.
Searching by body part: Again, you enter your city and state or zip code, click on body type (man, woman, or child), and then click “Next.” The system takes you to a list of body parts, including:
Finding Medicare Advantage Plan Providers
If you opt for a Medicare Advantage Plan, you can find information about doctors associated with those plans on Medicare.gov at Doctors, providers & hospitals in Medicare Advantage Plans. Select the type of plan (HMO, PPO, etc.) for general information about provider requirements. For example, an HMO generally requires you to get services from in-network providers, while a PPO allows you to see any doctor, with a lower cost to you if you see a provider in your network.
To look for in-network providers with a specific Medicare Advantage Plan, go to Find a 2021 Medicare Plan, answer a few simple questions, and the system will pull up a list of plans in your area with general information about each plan. You can request a printed directory or use the “Find a Doctor Tool,” which allows you to search by name, distance, condition, specialty, or language. If a particular Medicare Advantage Plan has been recommended to you by a friend or family member, you can typically access information about doctors, hospitals, and facilities on that company’s website.
Signing up for Medicare can be confusing, particularly when you first enroll. If you have a medical provider or hospital you trust, you want to ensure your coverage allows access. While you can find answers to your questions on the government website, most people need some help. If you need professional guidance to ensure you are enrolled in the best Medicare plan for you, our experienced agent will be happy to assist you through the process.