Is Urgent Care Covered by Medicare? - Urgent Care FAQ's

Is Urgent Care Covered by Medicare?

Is Urgent Care Covered by Medicare?

If you are in need of urgent medical care, you might wonder if urgent care centers accept your insurance. In the case of Medicare, this issue can be a little tricky. Here are the basic facts about urgent care centers and Medicare.

Urgent Care Centers Vary

While most urgent care centers will accept Medicare unconditionally, there are a few locations that will choose not to do business with Medicare-covered patients. These locations are rare, and are very open about this policy. In some cases there will be urgent care centers that have doctors who do treat Medicare-covered patients, as well as doctors who will not see Medicare-covered patients. The centers will explain this to you if you should encounter it.

The gist is that while Medicare does cover urgent care, urgent care centers each have the right to accept or deny any insurance provider. However, it is rare to find a center that does not accept Medicare insurance.

Opt-Out Physicians

Some physicians have chosen to opt-out of Medicare, and refuse to treat patients with this insurance. They require Medicare patients to sign a private contract stating that the patient may not file claims with Medicare for services rendered. However, according to federal regulation 40.28, which went into effect in January of 2013, patients at urgent care facilities may be treated by these opt-out physicians. The physicians are subject to additional paperwork, but the patient will not experience issues.

Accepting Physicians

Medicare-covered patients who find Medicare-accepting doctors will pay less and experience less hassle filing claims. These doctors have agreed to pre-determined fee schedules, so there is no discrepancy for filing claims.

Patients with Medicare can rest assured that there are facilities that accept their insurance. By being prepared with the facts beforehand, your office visits will go more smoothly and you will enjoy greater peace of mind.