If you’re approaching Medicare age or are already enrolled in Medicare, one of the most important questions you can ask your doctor is: “Do you accept Medicare assignment?” If you’re not asking, you could be spending more on your doctor’s visits and healthcare services than you need to. Let’s break it down…
What Does Medicare Assignment Mean?
If your doctor, hospital, or other healthcare providers say that they “accept Medicare assignment,” it means that they agree to accept the amount that Medicare approves for a service as full payment. In other words, you will not be billed more than what Medicare says the service is worth. There’s a ceiling, or a cost cap, placed on the care you receive.
Why Is Medicare Assignment a Good Thing?
If your provider accepts assignment, you’ll have…
- Lower out-of-pocket costs. You’ll only pay your premiums, deductible (if you haven’t met it yet), copayments, and coinsurance (usually 20% of the total)–nothing more.
- No surprise charges. Providers can’t tack on last-minute administration or in-office fees. You will pay the Medicare-approved amount.
- Simpler billing. In this case, when you receive care, your provider will bill Medicare directly first. Only after Medicare pays its share will you be billed for yours.
If your doctor doesn’t accept Medicare assignment but they are what’s dubbed a “nonparticipating provider,” you could end up paying up to 15% more for your care than Medicare’s approved rate–on top of your premium payments, deductible, coinsurance, etc.
If your doctor doesn’t accept Medicare assignment and they’re not a nonparticipating provider, they’re what’s called an opt-out provider, or someone who has completely opted out of Medicare. This means that they won’t accept any money from Medicare at their facility, and you’ll be responsible for 100% of your care costs.
For Medicare Supplement/Medigap Enrollees
Medicare Supplements are designed to cover what Medicare doesn’t pay, such as your 20% coinsurance. But even with a Supplement/Medigap plan in place, you should still ask whether your provider accepts assignment. This will prevent you from being overcharged right from the start.
A Costly Lesson: Why Asking About Assignment Matters
Take Mary, a 72-year-old retiree from Fort Worth, Texas. She recently needed a minor outpatient procedure on her knee. Mary assumed her doctor took Medicare, so she didn’t think to ask whether the office accepted Medicare assignment.
After the procedure, she was stunned when the bill arrived: Medicare approved the service at $1,000, but because her doctor was a nonparticipating provider, he charged 15% more than Medicare’s approved amount. That extra $150 came straight out of Mary’s pocket—on top of her regular 20% coinsurance of $200.
In total, Mary owed $350 instead of just the $200 she expected. And because her provider didn’t handle the claim, she also had the stress of filing the paperwork herself and waiting for reimbursement.
Mary later learned that if she had chosen a doctor who accepted Medicare assignment, she would have avoided the surprise surcharge, a paperwork headache, and paid less for the same treatment.
The Bottom Line
Medicare assignment keeps your costs predictable and your billing straightforward. That’s why it’s so important to check with your providers before receiving any care. While it’s always best to ask directly, you can search for participating doctors and facilities near you using Medicare’s online Care Compare tool.
If you’d like to learn more about what tools and products can help further protect you from unexpected medical expenses–like a doctor who doesn’t accept Medicare assignment–check out our article titled: ‘10 Essential Health Insurance Plans That Protect You From Unexpected Medical Costs.’ And if you’d like Medicare assignment broken down for you even further, our licensed agents at Empower Brokerage are here to guide you.
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This article was updated August 21, 2025.