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If a healthcare practitioner chooses to opt out of Medicare, it means that he or she opts out for all covered items and services that he or she furnishes. Each Opt-Out contract lasts for a minimum two-year period beginning the date the practitioner files and signs an affidavit that he or she has opted out of Medicare. Participating Medicare providers can opt out at the beginning of each calendar quarter, and non-participating physicians can opt out at any time. If a provider “opts-out” of Medicare, they must contract privately with Medicare patients or beneficiaries to provide covered services. Individuals who are able to “opt out” of Medicare include doctors (medicine, osteopathy, optometry, pediatric medicine, dental surgery), physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, clinical social workers, and clinical psychologists.