Does Urgent Care Take Medicare?

Medicare Part B covers visits to urgent care centers, as well as regular doctor appointments. You can visit any urgent care in the country that takes Medicare. The urgent care will bill Medicare, and you’ll only pay the portion of the bill in the form of deductibles or copays. Most urgent care facilities do accept Medicare. If the facility accepts Medicare, they’ll also take your Medigap plan. Occasionally a recipient comes across an urgent care center that is out of network with the Advantage plan. It’s essential to ask the facility each time before getting treatment.

The cost of a trip to urgent care can vary depending on where you live and what kind of treatment you need. A typical urgent care visit costs less than $200, while a trip to the emergency room can cost ten times as much.

Medicare Supplement Coverage for Urgent Care

A Medicare Supplement plan can help pay for an urgent care visit. Medicare supplements pick up costs that Medicare doesn’t pay. Many beneficiaries choose to enroll in Medicare Supplement Plan F so they have zero out of pocket costs. Normally, Medicare Supplement Plan N comes with a small copay for doctor visits, however, at an urgent care facility you can expect no copay.

Medicare Advantage Coverage for Urgent Care

Most urgent care centers accept Medicare Advantage. But, Medicare Advantage plans operate with provider networks. An urgent care center may participate in some Advantage plans, but not others. If you go to urgent care that isn’t in your plan’s network, you’ll pay more. Some policies, especially HMOs, don’t cover out-of-network care at all except in emergencies. Before you head to an urgent care center, confirm that it’s in-network for your Advantage plan.

Medicare Reimbursement for Urgent Care Centers

Most urgent care centers bill Medicare directly, but occasionally you may have to pay the bill upfront and seek reimbursement from Medicare. However, this is not common. Also, NEVER pay the Medicare Part B deductible upfront. The deductible Medicare will bill you after.

Urgent Care vs. ER vs. Retail Clinics

Urgent care, emergency rooms, and retail clinics are all designed to handle immediate medical needs. But there are differences in the kind of care they can provide.

Retail clinics in pharmacies and grocery stores use nurse practitioners. They can diagnose and treat common illnesses like flu, strep throat, and ear infections.

Urgent care centers have doctors on staff. They can handle the same minor illnesses as retail clinics. They can also take x-rays, treat sprains or broken bones, treat minor burns, and stitch up wounds. Urgent care centers aren’t equipped to handle serious medical emergencies. They don’t have specialists or surgeons and can’t do advanced testing like MRIs and CT scans. If your gut tells you that you need an emergency room level of care, don’t hesitate to go to the ER.

The emergency room is much more expensive than an urgent care facility. You can keep your healthcare costs down by going to urgent care for minor ailments. If you have a life-threatening emergency like a heart attack, stroke, head injury, potential overdose, or serious accident, you should always go to the emergency room.

Keep Your Urgent Care Costs Down with Medicare

No matter how healthy you are, accidents and minor illnesses do happen.  A Medigap plan removes the uncertainty about healthcare costs by paying the portion of the bill that Medicare doesn’t cover. You may pay nothing for an urgent care visit, or you may pay a small copay, depending on your plan. We can help you find a plan that meets your needs. To get started, call us or fill out our online form now.