Claire Dawson
Medicare is a health insurance program that provides coverage for individuals 65 and older, as well as some younger people with disabilities. It is accepted at most hospitals in the United States, with over 7,000 hospitals approved to provide care to Medicare beneficiaries. However, participation in Medicare is voluntary, and some hospitals may not accept it. Those that do not accept Medicare are typically VA hospitals and active military hospitals, which operate with veterans and military benefits. Additionally, some public hospitals may choose not to participate in Medicare. It is important to verify whether a hospital participates in Medicare or is in your specific plan's network. Online search tools are available to help individuals find hospitals that accept Medicare near them.
| Characteristics | Values |
|---|---|
| Number of hospitals that accept Medicare in the US | Over 7,000 |
| Hospitals that do not accept Medicare | VA hospitals, active military hospitals, and some public hospitals |
| Medicare Advantage Plans | Offered by Medicare-approved private insurance companies; may limit your access to a particular network of healthcare providers |
| Medicare Advantage Plan coverage | Emergency and urgent care, inpatient and outpatient services |
| Finding a hospital that accepts Medicare | Use the Medicare online tool or Medicare.gov Care Compare tool |
| Out-of-pocket costs | Yes, even if the hospital accepts Medicare |
| Medicare Part A | Most people with Part A do not pay a monthly premium but are responsible for deductibles and hospital coinsurance |
| Lifetime reserve days | 60 extra days paid for by Medicare for the entirety of one's lifetime |
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What You'll Learn
Hospitals that don't accept Medicare
Medicare is a health insurance program that provides coverage for individuals aged 65 and over, as well as those with qualifying disabilities or end-stage renal disease. While most hospitals in the United States accept Medicare, it is not mandatory for them to do so. As such, there are some hospitals that do not participate in the Medicare program.
The hospitals that typically do not accept Medicare include Veterans Affairs (VA) hospitals and active military hospitals. These hospitals cater to veterans and active military personnel, utilizing VA and military benefits instead of Medicare. However, it is important to note that VA hospitals are required to treat any veteran needing emergency care, regardless of their insurance status.
In addition to VA and military hospitals, there may be some public hospitals that choose not to participate in Medicare. These hospitals have the option to opt-out of Medicare, which means Medicare will not cover any services provided by these hospitals, except in emergency situations. It is worth noting that providers who opt out of Medicare must do so for a minimum of two years and can choose to continue their opt-out status or accept Medicare on a case-by-case basis after this period.
The specific hospitals that do not accept Medicare can vary and may change over time. To find an up-to-date list of hospitals that accept Medicare, individuals can utilize online search tools provided by Medicare, such as the Care Compare tool or the Health Care Comparison tool. These tools allow users to search for hospitals, doctors, and other healthcare providers that participate in Medicare, as well as compare ratings and other important information.
While most hospitals accept Medicare, it is always advisable to verify a hospital's participation status before seeking treatment. Additionally, even at hospitals that accept Medicare, patients may still be responsible for certain out-of-pocket costs, deductibles, and coinsurance. Understanding the terms of one's insurance coverage and the potential financial responsibilities is crucial when seeking healthcare services.
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Finding Medicare-approved hospitals
Medicare is a form of health insurance for individuals aged 65 and above, and younger people with disabilities or specific health issues. Most hospitals in the United States accept Medicare, but participation is voluntary, so not all hospitals do. Generally, the hospitals that do not accept Medicare are VA hospitals and active military hospitals, which operate with veterans and military benefits instead. There are also some public hospitals that may choose not to participate in Medicare.
If you have Original Medicare (Parts A and B), you can seek care from any hospital or healthcare provider that accepts Medicare in the United States. If you have Medicare Advantage, you typically need to seek care from an in-network provider. However, if you require emergency care, you can go to any hospital that accepts Medicare.
There are several ways to find a Medicare-approved hospital near you. Firstly, you can use the online Medicare.gov Care Compare tool. Here, you can enter your city or state, select the type of provider you need, and click "search". The tool will return a list of different types of hospital facilities, which you can filter based on distance from your home, overall star ratings, patient survey ratings, hospital type, and whether the hospital provides emergency services. You can also save hospitals or compare multiple hospitals side-by-side, and use the map feature to determine whether the hospital is near your location.
Additionally, you can use the Medicare.gov Live Chat or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) to get assistance with finding hospitals or facilities in your area. The Find a Medicare Provider tool can help you get information about providers and facilities, including hospitals, based on your location and needs.
It is important to note that even if a hospital accepts Medicare, you are still responsible for certain out-of-pocket costs. Hospital care is covered under Medicare Part A, and most people with Part A do not pay a monthly premium. However, you still have to pay for deductibles and hospital coinsurance.
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Out-of-pocket costs
While most hospitals in the United States accept Medicare, participation is voluntary, and some hospitals do not. If you have Original Medicare (Parts A and B), you can seek care from any hospital or healthcare provider that accepts Medicare in the US. If you have Medicare Advantage, you typically need to seek care from an in-network provider, except in the case of emergency care.
Regardless of whether a hospital accepts Medicare, you are still responsible for certain out-of-pocket costs. Hospital care is covered under Medicare Part A, and most people with Part A do not pay a monthly premium. However, you must pay for deductibles and hospital coinsurance. For instance, for a hospital stay in 2025, you'll pay a $1,676 deductible per benefit period. There is no yearly limit on what you pay out-of-pocket unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy, or you join a Medicare Advantage Plan.
Medicare Part B (Medical Insurance) has a standard monthly premium of $185 in 2025. The Part B deductible is $257 per year, and the Part B coinsurance is 20% of the cost for each Medicare-approved service or item. This can make up a significant part of your total out-of-pocket costs.
Medigap policies can help with out-of-pocket costs, but each insurance carrier sets its own premium for Medigap policies, so the price you pay depends on your chosen policy. Some Medigap policies include extra benefits like coverage when you travel out of the country.
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Medicare Advantage plans
Before enrolling in a Medicare Advantage Plan, it is important to verify that the hospitals and specialists you may need are included in the plan's network. You can use online search tools, such as the Medicare.gov Care Compare tool, to find hospitals that accept Medicare and those that are in your Medicare Advantage plan network. Additionally, you can contact Medicare or your health plan directly to understand any specific requirements, such as the need for pre-authorization or referrals.
It is also crucial to consider the potential impact on your employer or union coverage. In some cases, enrolling in a Medicare Advantage Plan may result in the loss of employer or union coverage not only for yourself but also for your spouse and dependents. Therefore, it is recommended to consult with your employer, union, or benefits administrator about their rules and regulations before joining a Medicare Advantage Plan.
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Medicare Part A and Part B
Medicare is federal health insurance for anyone aged 65 and older and some people under 65 with certain disabilities or conditions. Most hospitals in the United States accept Medicare, but participation is voluntary, and there are some exceptions. Generally, the hospitals that do not accept Medicare are VA hospitals and active military hospitals, which operate with veterans and military benefits instead. There are also some public hospitals that may choose not to participate in Medicare.
- Have worked the required amount of time under Social Security, the Railroad Retirement Board (RRB), or as a government employee.
- Are getting or are eligible for Social Security or RRB benefits.
- Are the spouse or dependent child of a person who has worked the required amount of time under Social Security, the RRB, or as a government employee; or are getting Social Security or RRB benefits.
Part B is Medicare's medical insurance. If you have Original Medicare (Parts A and B), you can seek care from any hospital or healthcare provider that accepts Medicare in the United States. However, if you have Medicare Advantage, you typically need to seek care from an in-network provider, except in the case of emergency care.
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Frequently asked questions
Most hospitals in the US accept Medicare, but participation is voluntary, so not all hospitals do.
You can use the online Medicare.gov Care Compare tool or Live Chat, or call 1-800-MEDICARE to find hospitals in your area that accept Medicare.
If you have a Medicare Advantage plan, you typically need to seek care from an in-network provider. However, in an emergency, you can seek care at any ER or hospital in the country, and your plan will cover the emergency services as if they were in-network.
Even if the hospital accepts Medicare, you're still responsible for certain out-of-pocket costs, including deductibles and coinsurance. If your doctor accepts the Medicare-approved amount as full payment, your out-of-pocket costs may be lower.
If your doctor, provider, or supplier doesn't accept Medicare, you might have to pay the full amount at the time of service. They should submit a claim to Medicare for any Medicare-covered services, but they can charge up to 15% more than the Medicare-approved amount for non-participating providers.
