How to find a doctor who accepts Medicaid

Start with the plan on your Medicaid card

Many states use private insurance companies to run their Medicaid programs. HealthCare.gov says some Medicaid programs pay for your care directly, and others use private insurance companies. If you have a plan name on your card, that plan keeps a list of doctors in its network. A network is the group of doctors who have agreed to take that plan.

Federal rules require plans like these to offer a searchable online directory, and a paper copy on request. Each entry has to show where the doctor is and how to call the office. It must also say whether the doctor will accept new enrollees. The entry lists the languages offered and the specialty, and it says whether the doctor offers visits by video. An online directory must be updated within 30 days after the plan learns of a change.

You can search by specialty, such as eye care or dermatology, and by distance. If you do not have a computer, call the member services number on the back of your card. If your card is lost, our Medicaid card guide explains how to replace it. Someone there can read you the list for your area.

If your state pays doctors directly

In some states, Medicaid has no separate plan for you, and the state itself pays the doctor. In that case, look on your state Medicaid agency's website for a provider search or a find-a-provider tool. If you cannot find one, call the state's Medicaid helpline and ask how members find doctors. You can look up the agency from the HealthCare.gov Medicaid page, where you pick your state.

When you have a name, check it twice. Ask the office whether it is enrolled with the state's Medicaid program today. Then bring your Medicaid card to the visit. A photo ID helps too, since the front desk can check your coverage on the spot.

Call the office before you book

Lists can be out of date, so a quick call saves a trip.

• Do you take Medicaid, and do you take my plan by this exact name?
• Are you taking new patients my age right now?
• Do I need a referral from a primary care doctor first, or can I call you directly?
• How long is the wait for a first visit, and is there a cancellation list?
• Do you offer video visits?

Keep a notebook with the date, the name of the person you spoke to, and their answers. If the plan sent you to an office that says no, your notes will help when you call the plan back.

Eye doctors, therapists and skin doctors

The steps are the same for every type of doctor, but a few details change from one kind to the next. For eye care, a state decides whether Medicaid pays for adult glasses and eye exams. MACPAC, a federal advisory group on Medicaid, lists eyeglasses among the benefits that states may choose to offer. It lists optometrist services in that group as well. The rule is firmer for children, since Medicaid.gov says children under 21 must get diagnosis and treatment of vision problems, including eyeglasses. Our eye exam cost guide helps if your state does not cover an adult exam.

For a therapist, ask the plan whether mental health care has its own phone line or its own list. Many therapists have full schedules, so ask each office how long the wait is, and ask whether it offers video visits. Community health centers often provide mental health care, and they charge by income. If you are in crisis or thinking about harming yourself, call or text 988. This is the Suicide and Crisis Lifeline, and it is free and open all day and night. Our therapy cost guide lists more low-cost routes.

A dermatologist is a skin doctor, and you should ask whether you need a referral from your primary care doctor. Ask how long the wait is for a first visit, and ask to join the cancellation list. While you wait, your primary care doctor can look at the skin problem and may be able to speed up the referral.

When no one is taking new Medicaid patients

This happens often, and it is not your fault.

1. Call the plan again and say that you have called several offices without success. Federal guidance says managed care plans must make covered services available to their members in a timely way. Ask the plan to find you an appointment.
2. Try a community health center near you first. HRSA says these centers serve everyone, even people who cannot pay, and they adjust fees by income and family size. Ask if they take your Medicaid plan, and use our community health centers guide to find one.
3. Ask about video visits, since plan directories must say whether a doctor offers care by telehealth.

Your primary care doctor can help with the search too. The office may have a contact at a specialist's office who can move you up the list. If nothing works, a complaint form is the next step. Plans and state agencies have a process for members who cannot get care, and your member handbook should explain it.

What the Foundation's directory can and cannot do

The Foundation's directory lists about 20,000 cash-pay doctors. These are doctors who post a price you pay yourself, and many offer a monthly membership that usually costs $50 to $200 a month. They are not a list of Medicaid providers, so please use your plan's directory for Medicaid visits.

A cash-pay doctor can still help if you are waiting for Medicaid to start or cannot find a Medicaid office with an open slot. You can search for a cash-pay doctor near you. For help with the first step, read how to apply for Medicaid. This page is general information and not medical advice. In an emergency, call 911 or go to the nearest emergency room.