Some Doctors Have Opted Out of Medicare Entirely.
Sign Their Form, and the Whole Bill Is Legally Yours
Quick Read – Psychiatrists lead Medicare opt-outs at 8.1%, and signing their private contract eliminates Medicare coverage, fee caps, and Medigap reimbursement entirely. – Weekly $400 psychiatric sessions create a $1,600 monthly cash bill that doesn’t count toward the Part B deductible or qualify for Medigap. – Before any appointment, check the CMS Provider Opt-Out Affidavits Lookup Tool and ask directly whether the doctor accepts Medicare assignment or has opted out. – A 68-year-old on Original Medicare calls a well-reviewed psychiatrist, gets an appointment, and receives a two-page “private contract” before the first visit. Buried in the form is an acknowledgment that Medicare will not pay for the doctor’s services, no limiting charge applies, and the patient accepts full responsibility for the bill. The receptionist calls it a formality.
It is not. Signing turns the appointment into a private cash-pay arrangement, with no Medicare reimbursement and no help from Medigap. This is the opt-out physician trap, and it appears more often in certain specialties.