Back
Back

Speak with a licensed insurance agent

1-888-457-9778 TTY 711, 24/7

Does Medicare Urgent Care?

Medicare covers urgent care and certain other medically necessary treatments you may receive at an urgent care center. Learn more about Medicare outpatient coverage and emergency care benefits.

 

Medicare Part B and Medicare Advantage plans cover urgent care for medically necessary treatment. It's important to understand Medicare urgent care coverage if beneficiaries are faced with sudden illness or injury. 

In this guide, we will explore the different aspects of Medicare coverage for urgent care services, and we'll highlight ways you may be able to maximize your Medicare coverage if Medicare Advantage (Medicare Part C) plans are available from private insurance companies where you live that pay for extra health care benefits.

When Does Medicare Pay for Urgent Care in Medical Emergencies?

In most cases, Medicare Part B covers medically necessary urgent care services for injuries, sudden illness or other health concerns.

This means that if you have Original Medicare (Part A and Part B) or a Medicare Advantage (Part C) plan, your urgent care visit should be covered as long as the provider accepts Medicare assignment.

  • You may still need to pay a deductible before your coverage kicks in. For example, with Medicare Part B, there is an annual deductible amount you must meet before receiving benefits. Medicare Advantage plan deductibles may vary, as they are sold by private insurance companies.

  • Copayments also apply after meeting the deductible, and the costs may vary depending on what types of emergency services you receive.

In the event of a medical emergency, it's important to seek urgent care services immediately. Medicare covers emergency room services, which means you can receive care at any hospital that accepts Medicare. 

If you receive emergency room emergency services from a hospital that is not Medicare-approved, you may be responsible for the full cost of the visit.

What Urgent Care Isn't Covered by Medicare?

While Medicare covers many emergency department services, there are some exceptions. For example, if you receive care at an urgent care clinic that is not Medicare-approved and isn't covered, you may be responsible for the full cost of the visit. 

Additionally, Original Medicare does not cover prescription drug coverage, so any medications prescribed during your visit may not be covered.

Conclusion

Understand Medicare coverage before you seek urgent care services. Knowing what services are covered by Medicare and how to determine eligibility can help ensure that you receive the care you need.

Call to speak with a licensed insurance agent who can answer your Medicare questions and help you compare Medicare Advantage plans where you live, including what they cost, the doctors they cover and the benefits that may be available.

About the author

Profile Image of Matt Clements, Senior Editor

Matt Clements

Matt Clements is the Senior Editor and Content Manager with MedicareMatch. He specializes in health industry research and informational content related to Medicare, Medicaid, retirement benefits and other vital but complicated topics.

His research has been featured by news outlets including Forbes, MarketWatch, Yahoo! Finance and more.

A current resident of Raleigh, Matt is a graduate of the University of North Carolina with a bachelor’s degree in English.

  • Does Medicare Cover Ambulance Services?

    Medicare covers ambulance transportation in the case of an emergency or if your doctor says it's medically necessary. Learn more about how the parts of Medicare cover ambulance transportation.

    Read more

  • Does Medicare Cover Hospice Care?

    Medicare covers hospice care when your doctor certifies you're terminally ill and you meet other requirements. Learn more about how Medicare covers hospice for you or your loved one.

    Read more

  • Does Medicare Cover Nursing Home Care?

    While Medicare covers skilled nursing facility care, it doesn't typically cover nursing home care. Learn more about the difference and find out when and how Medicare covers nursing care.

    Read more

  • Does Medicare Cover Physical Therapy?

    Medicare Part B and Medicare Advantage (Part C) plans cover physical therapy for medically necessary treatment related to a specific injury, illness or condition. Learn more about Medicare physical therapy coverage and costs.

    Read more

  • Which Medicare Plan Covers Dental?

    Medicare Advantage (Part C) plans may cover routine dental care and other dental services Original Medicare (Parts A and B) doesn't cover. Learn more and find out how to compare plans where you live.

    Read more

  • Does Medicare Cover Gym Memberships?

    Medicare Advantage plans may cover gym memberships or other fitness benefits like SilverSneakers that Original Medicare (Parts A and B) doesn't cover. Learn how to compare Medicare Advantage plans and their benefits.

    Read more

  • Does Medicare Cover Eye Exams?

    Medicare Advantage plans may cover eye exams, though Original Medicare (Parts A and B) does not cover routine vision care. Learn how to find Medicare Advantage plans that cover eye exams and eyeglasses or contact lenses.

    Read more

  • Does Medicare Cover Over the Counter Products?

    While Original Medicare (Parts A and B) doesn't cover over-the-counter products, Medicare Advantage (Part C) plans that cover OTC health items may be available in some areas. Learn more and find out how to learn if any plans are available where you live that cover OTC items.

    Read more

  • Does Medicare Cover Hearing Aids?

    While Original Medicare doesn't cover hearing aids, some Medicare Advantage plans may offer hearing coverage. Learn more and find plans that offer hearing benefits Original Medicare doesn't cover.

    Read more

  • Medicare Grocery Benefit

    Some Medicare Advantage plans may offer a grocery benefit, such as healthy meal options or a flex card you can use for food. Learn more and find out if any Medicare plans with grocery benefits are available where you live.

    Read more

Welcome to the first step in your Medicare Advantage journey.

Or call a licensed insurance agent

1-888-457-9778 TTY 711, 24/7

1-888-457-9778