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Does Urgent Care Take Medicare?

02/08/2023
  • Medicare with Melissa

Yes, most urgent care centers accept Medicare as a form of payment. This is great news for Medicare beneficiaries, as urgent care centers are often more affordable and faster than a trip to the emergency room. In fact, Consumer Reports says that only 2-4% of urgent care visits result in a trip to the ER.

However, it’s still important to be aware of any additional fees that may be associated with using Medicare at an urgent care center. These fees can include co-pays, deductibles, and other charges. To avoid any surprise medical expenses, check with your provider before visiting an urgent care center to find out what your coverage includes.

What Is Medicare?

Medicare is a government funded healthcare program that provides access to quality care for those who are 65 or older, as well as to certain younger adults with disabilities or end-stage renal disease. It provides a variety of healthcare services such as hospital care, doctor visits, home health care, and prescription drug coverage. Medicare consists of four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drugs). Medicare also offers several supplemental plans and other coverage options to help with out-of-pocket costs.

What Is Urgent Care?

Urgent care is a type of medical care that is designed to provide quick, convenient, and accessible care for minor illnesses and injuries. It’s a great option for those times when your primary care physician isn’t available, and you need medical attention right away. Urgent care centers are typically open 7 days a week, offer extended hours, and don’t require appointments.

The care you receive will depend on the facility you visit, but generally, urgent cares are equipped to provide treatments for colds and flus, cuts and scrapes, broken bones, back pain, and much more. Some urgent cares also offer special services like X-rays, lab work, and IV fluids. Ironically, many primary care physicians these days have to refer you to another facility for these special services, because they no longer do it themselves. So, often visiting urgent care can be a huge time-saver.

How Much Does Urgent Care Cost?

The cost of an urgent care visit can vary widely depending on the type of care that is needed and whether you have insurance. Generally, an urgent care visit costs between $100 and $200. However, if more extensive testing or treatment is required, the cost can be significantly higher. Depending on the type of health coverage you have, you may be responsible for copays, coinsurance, and/or deductibles. Understanding your insurance coverage is key to understanding what your out-of-pocket costs will be for urgent care services.

Emergency Room vs. Urgent Care

When it comes to health care needs that require immediate attention, people often debate between going to an Emergency Room (ER) or an Urgent Care center. While both options provide access to medical professionals, there are some key differences between the two.

An ER is typically found in a hospital and is equipped to handle more serious, life-threatening illnesses and injuries. ER doctors and nurses are on-hand 24/7 and can do more complex diagnostic procedures, such as ultrasounds, CT scans, and X-rays. They can also perform minor surgeries, stabilize critical medical conditions, and even administer medications. On the downside, ER visits are more expensive and usually take a lot longer to be seen by a doctor.

Urgent Care centers, on the other hand, are typically walk-in clinics, and are equipped to handle minor medical issues such as colds, flus, rashes, and minor injuries. Urgent Care centers usually have shorter wait times and lower costs than ER visits, since they are not equipped with the same level of medical technology.

In short, if you are experiencing a minor medical issue, an Urgent Care center may be the best option. However, if you are having a life-threatening medical emergency, an Emergency Room may be the better option.

Medicare Supplement Plans and Urgent Care

Most urgent care centers accept Medicare Supplement plans, which provide additional coverage to what is offered with traditional Medicare. This additional coverage can include copayments, coinsurance, and deductibles, allowing seniors to receive the medical care they need without breaking the bank. Medicare Supplement plans are also accepted at inpatient and outpatient hospital facilities, as well as skilled nursing facilities.

It’s important to note, however, that not all plans are accepted by all healthcare providers, so it is important to check with the urgent care center you plan to visit to ensure they accept your Medicare Supplement insurance plan.

Medicare Advantage Plans and Urgent Care

Most urgent care centers also take Medicare Advantage plans. Medicare Advantage plans are a type of health insurance plan that is provided by private insurance companies that work in conjunction with Medicare. These plans have specific provider networks for beneficiaries. Certain Medicare Advantage plans may include urgent care centers as part of their network, while some may not (HMO vs PPO). It’s advised to find out ahead of time if services are covered by your plan to ensure that you are not left with any unexpected costs at the end of your visit to the Urgent Care center.

Conclusion

Urgent care centers typically accept Medicare as a form of payment, although there may be additional out-of-pocket costs depending on the services received. Additionally, most urgent care centers accept Medicare Supplement and Medicare Advantage plans. Just keep in mind, every urgent care center is different. Some may have different policies and restrictions regarding the acceptance of Medicare and other forms of health insurance.

It’s recommended to contact the urgent care center you plan to visit to verify your insurance and coverage. By doing so, you will ensure that you get the medical attention you need without incurring any additional, unforeseen expenses in the future.

Do you need more information about Medicare coverage for Urgent Care? Look no further. At Senior Healthcare Solutions, our team of licensed agents are here to answer all your questions. Give us a call at 866-MEDIGAP (866-633-4427) to speak with one of our Medicare professionals today. We look forward to helping you!

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.

-Melissa

Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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