Published by: Medicare Rights Center
Once you know what you want from a primary care provider (PCP) or specialist, you may want a list of providers in your area from which to choose. You may ask for referrals from friends, relatives, coworkers, and/or neighbors. You can also check with your insurance plan, medical societies, hospitals, and accreditation organizations. Be aware that while these sources can provide a list of doctors, they will not necessarily provide quality information.
Note: If you have Original Medicare, make sure to see participating providers wherever possible. If you have a Medicare Advantage Plan, make sure to follow your plan’s network rules.
The following sources can help you find lists of healthcare providers and learn more about their quality.
Medicare: To find a provider who accepts Original Medicare, call 1-800-MEDICARE (633-4227) or use Medicare’s Physician Compare tool. If you have a Medicare Advantage Plan, contact your plan for a list of in-network providers.
American Medical Association (AMA): The AMA offers a search engine on its website where you can find doctors in your area by specialty. You can also check on training and board certification.
The American Board of Medical Specialties (ABMS): ABMS is a nonprofit organization consisting of 24 medical specialty boards that oversee physician certification. You can look up a specific doctor’s credentials or find doctors who are board-certified in a specific specialty in your area. The service is free, but you must sign up before you can do a search. ABMS also publishes a book listing doctors: The Official ABMS Directory of Board-Certified Medical Specialists is available at many hospitals, Social Security offices, Area Agencies on Aging, senior centers, and local libraries.
Administrators in Medicine (AIM): If you know the name of a particular doctor, you can look them up on AIM’s website. AIM is a group of state medical board directors. You can see physicians’ licensing backgrounds and whether or not they have had any disciplinary action taken against them.
While these resources cannot ensure that a particular doctor is the best one for you, they do provide information on a doctor’s knowledge and skills. Some tell you which doctors are board-certified, which means they have completed a training program in a specialty and have passed a board exam on the subject. Keep in mind, though, that while board certification is a good measure of a doctor’s knowledge, it does not guarantee a doctor’s quality or that they will be a good fit for you.