Is Urgent Care Covered by Insurance?

Is Urgent Care Covered by Insurance?

Before you decide to get medical treatment at an urgent care center, you might wonder if your insurance will cover the visit. Here is a guide to understanding when your insurance will cover urgent care.

When Are You Covered?

Each insurance provider determines if it covers urgent care centers or not. However, in most cases insurance providers will cover urgent care, but patients will be expected to pay a co-payment or deductible. In some rare cases, an urgent care center may choose not to accept your insurance, even if your insurance provider would otherwise pay for the care.

While you could safely assume that an urgent care center will take your insurance, it is always best to call ahead and be certain.

How Much Does It Cost?

For routine, in-network care the average urgent care patient will be charged $20-40 of co-payment, regardless of additional services. For routine, out-of-network care the average person might be charged a co-payment of $35-100, depending upon the facility. If you are left owing additional money, your insurance provider will bill you after processing your bill.

Uninsured patients can expect to pay the base fee of $71-125 for an office visit, in addition to any extra services rendered (such as medications, IVs, x-rays, or shots). Unfortunately, uninsured patients must pay for their visit in full before leaving the urgent care center. Payment plans are not available at most urgent care centers.

Is Urgent Care Cheaper Than an ER?

Urgent care is always more affordable than ER visits, which cost upwards of $1,000. The average visit in 2012 was $1,318, without additional services such as MRIs.

When you need urgent medical treatment but do not feel that a trip to the emergency room is in order, urgent care is often the best choice. However, it is still a good idea to check with your insurance provider and a specific urgent care location for more information.