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Does Medicare Cover Urgent Care?

by Christian Worstell   |   Published Oct 03, 2019   |    Reviewed by John Krahnert

Medicare Part B (Medical Insurance)typically covers most urgent care. There are out-of-pocket costs that you will likely have to pay for these benefits, however.

Learn more about the qualifications for Medicare urgent care coverage and how to get help covering some of the additional costs.

Medicare Urgent Care Coverage

Urgent care typically falls under the Medicare coverage category of emergency department services. Medicare Part B covers all emergency department services within the U.S., which includes any service or care provided when you have an injury, sudden illness or condition that worsens very quickly.

Urgent Care Locations vs. Emergency Room Care

Both urgent and emergency room care are covered by Medicare Part B as outpatient care. However, there are several advantages to receiving care at an urgent care center rather than a hospital ER. A visit to the urgent care clinic can often mean:

  • Lower costs
  • Shorter wait time

Urgent care centers are typically staffed by physicians, physician’s assistants and nurses, just like any other doctor’s office or ER — the difference is that they aren’t equipped to treat life-threatening injuries or illnesses. As long as your injury or illness is non life-threatening, a visit to the urgent care clinic may save you money and time.

Medicare Part A does not cover urgent care clinic visits, but it will help cover some of the costs of inpatient hospital care, lab tests, surgeries and some other costs.

How Does Medicare Pay for Urgent Care Location Visits?

As long as the urgent care center you go to participates in Medicare, your Medicare insurance will typically cover 80 percent of theMedicare-approved cost for services, and you’ll pay the remaining 20 percentcoinsurance after you have met your Medicare Part B deductible (which is $183 per year in 2018).

 

Medicare Supplement Insurance can help cover your out-of-pocket urgent care costs.

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Or call 1-800-995-4219 to speak with a licensed insurance agent.