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What does it mean when doctors “opt out” of Medicare? Skip to content

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What does it mean when doctors “opt out” of Medicare?

En español | The vast majority of doctors choose to participate in Medicare, but some do opt out. Opted-out doctors cannot bill Medicare for treating you, and you cannot claim recompense from Medicare either, so you end up paying the full cost of whatever the doctor charges.

If you go to a doctor who’s opted out, he or she should ask you to sign a form, which is essentially a private contract between the two of you, in which you agree to pay the entire bill out of your own pocket.

However, if an opted-out doctor does not get you to sign this agreement or if you’re in no position to sign one — for example, if you’re unconscious in the emergency room — you are not responsible for paying the bill.

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