Does Medicare Cover Urgent Care Visits?
Yes, Original Medicare does cover urgent care visits. If you have Original Medicare (Parts A and B), you can receive urgent care services at any facility that accepts Medicare. This includes urgent care centers and walk-in clinics.
However, Medicare will not cover your urgent case visit until you fully pay your Medicare Part B deductible for the year. Until then, you will have to pay out of pocket. After you pay your yearly deductible, Medicare Part B covers 80% of the Medicare-approved amount, and you’ll be responsible for the remaining 20%.
How Much Will an Urgent Care Visit Cost With Original Medicare?
An average urgent care visit costs between $100 and $200 before Medicare pays its portion. The actual cost will vary based on the specific services you receive. For example, if you go to an urgent care clinic for a sprained ankle, you may receive only an x-ray and a wrap.
In contrast, if you go for a more complex issue, such as a urinary tract infection or pneumonia, you may require lab work, a chest x-ray, and antibiotics, all of which will raise the cost further. As always, asking for an estimate of costs upfront is essential so there are no surprises when the healthcare bill arrives.
Should I Go to Urgent Care or ER With Medicare?
While the ER is equipped to handle life-threatening situations, urgent care centers can provide care for many non-life-threatening illnesses and injuries. So, urgent care has more advantages for Medicare beneficiaries in most non-life-threatening situations.
Here are the two main benefits of going to an urgent care center instead of the ER:
- Costs: Urgent care costs are generally between $100 to $200, while emergency room visits can cost $1,200 to $1,300 on average.
- Time: Urgent care facilities typically have shorter wait times than emergency rooms. On average, the wait time at a walk-in clinic is around 30 minutes, while an emergency room wait can be up to 4 hours.
If you’re unsure which option to choose, call your doctor or speak with a medical professional or healthcare provider to determine the best action based on your symptoms.
How Can I Find an Urgent Care Center Near Me That Accepts Medicare?
There are a few ways to go about this.
- You can use Medicare’s Provider Locator tool on their website to search for providers in your area.
- You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to ask for a list of providers.
- Additionally, many urgent care centers will advertise if they accept Medicare, so keep an eye out for signage or ask the staff when you arrive.
Bottom Line
Urgent care visits can be stressful and often come with unexpected costs, but with Medicare coverage, you can rest a little easier knowing you have options. Remember, while Medicare covers urgent care, you’ll still be responsible for paying your Medicare Part B deductible and coinsurance costs. When deciding whether to go to urgent care or the ER, consider the severity of your symptoms and speak with a medical professional if you’re unsure.
Sources: American Family Care – Medicare.gov – HelpAdvisor
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