The short answer is: Yes, the vast majority (over 90%) of non-pediatric hospitals in the U.S. accept Original Medicare.
However, “Accepting Medicare” is not a simple yes-or-no checkbox. There are nuances involving provider networks, specific doctor contracts, and facility types (such as VA hospitals) that can leave patients with unexpected bills.
This guide explains exactly how hospital acceptance works, the hidden costs of “Non-Participating” providers, and how to verify your local hospital’s status before you arrive.
The “Network” Trap: Medicare Advantage vs. Original Medicare
Before asking if a hospital accepts Medicare, you must first clarify which version of Medicare you have. This is the most common reason patients face surprise rejections.
- If you have Original Medicare (Part A & Part B): You have nationwide access. You can visit any hospital or doctor in the U.S. that accepts Medicare. You do not need to worry about “networks” or referrals.
- If you have a Medicare Advantage Plan (Part C): You are likely restricted to a local network. Even if a hospital “Accepts Medicare,” they may not be in your specific plan’s network. If you go out-of-network for non-emergency care, your plan may deny coverage entirely.
Key Takeaway: If you have a Medicare Advantage plan, do not ask the hospital “Do you accept Medicare?” Instead, ask: “Are you in the network for [Your Specific Insurance Carrier]?”
Planning a Trip? Don’t Leave Your Coverage Behind.
Hospital acceptance rules change the moment you cross state lines (or international borders). We have compiled a Traveler’s Guide to Medicare to help you avoid out-of-network bills while you are away from home.
Inside this free guide:
- Domestic Travel: How to find “Participating” hospitals in other states.
- International Emergencies: Does any foreign hospital accept Medicare? (Page 6).
- Moving State-to-State: A checklist for transferring your care to a new location.
The 3 types of Medicare doctor contracts
Even within Original Medicare, not all “acceptance” is the same. Doctors and hospitals fall into three contracting categories. Knowing which one your provider falls into is the only way to predict your final bill.
|
Provider Status |
Does Medicare Pay? |
What You Pay (Original Medicare) |
The “Hidden” Risk |
|
Participating |
Yes |
20% of the approved amount. |
None. They agree to accept the Medicare rate as payment in full. |
|
Non-Participating |
Yes |
20% coinsurance + up to 15% extra. | Excess Charges. They can legally bill you 15% over the Medicare rate. |
|
Opt-Out |
No |
100% of the cost. |
Full Cost. Medicare pays nothing; you pay private rates. |
Pro Tip: When scheduling a procedure, ask the billing department: “Do you accept Medicare Assignment?”
- If they say “Yes,” they are a Participating provider (Best financial protection).
- If they say “We accept Medicare, but not assignment,” they are Non-Participating (Expect the 15% surcharge).
Which hospitals accept Medicare
While rare, there are specific facilities where your Medicare card will not work:
- Veterans Affairs (VA) Hospitals: These are funded by the federal government separately. You generally cannot use Medicare benefits at a VA facility (and vice versa).
- Concierge/Boutique Practices: Some private physicians have “Opted Out” of Medicare entirely to charge premium rates. They must have you sign a contract acknowledging that you agree to pay the full cost out-of-pocket.
- Active Military Hospitals: Facilities serving active duty personnel typically do not accept Medicare.
How to find hospitals near you that accept Medicare
If you want to be absolutely certain that your local hospital is “Participating” (accepting assignment), follow these steps:
- Use the Official Search Tool
Visit Medicare.gov’s Care Compare tool. You can search for hospitals, nursing homes, and dialysis centers. The tool will explicitly state if the facility “participates in Medicare.”
- Verify with the Billing Department
Websites can be outdated. We recommend calling the hospital’s billing office directly.
- Script: “I have Original Medicare. Do you accept Medicare Assignment for both the facility fees and the attending physicians?”
Navigating your care with confidence
The U.S. healthcare system is designed to be accessible for seniors, but “access” doesn’t always mean “zero cost.” By understanding the difference between Participating and Non-Participating providers, you can avoid surprise bills and ensure your hospital stay focuses on healing, not finances.
