How Opt-Out Affects Medicare Beneficiaries - JF Part B
Educational Resources
How Opt-Out Affects Medicare Beneficiaries
When a provider opts out of Medicare:
- Beneficiaries agree to pay the provider directly for all services covered by the private contract.
- Medicare does not reimburse any portion of the charges.
- Medicare fee limits do not apply to the provider's charges.
- Beneficiaries may choose to receive care from Medicare-enrolled providers instead.
These terms must be documented in a private contract between the provider and each Medicare beneficiary.
Last Updated May 28 , 2026