Is Urgent Care Covered By Insurance?
Urgent care centers are an excellent resource for quality healthcare when your regular physician’s office may be closed. Although urgent care centers are typically cheaper than a doctor’s office visit, different services can drive up the cost dramatically. Most urgent care centers accept all major health insurance plans, including Medicare and Medicaid.
If your health insurance plan has high deductibles and copays, going to urgent care may be very expensive. Luckily, with a Mira membership, you can get access to low-cost urgent care visits at centers near you for only $45 per month. Mira members get up to 80% off over 1,000 prescription medications and same-day lab testing. Sign up for Mira today.
Health Insurance Accepted by Urgent Care Facilities
Urgent care is an excellent healthcare alternative to a primary care provider or hospital if you need quick and affordable medical attention. Although advertised as being low-cost, many urgent care centers end up charging additional fees for x-rays, lab tests, and other extras on top of the initial visit fee. These prices can add up without insurance, making the overall visit at an urgent care very expensive.
Fortunately, most urgent care centers accept major health insurance plans. Below is a chart that outlines some of the most popular urgent care companies across the country and whether they accept the five most popular health insurance plans. According to Healthpayer Intelligence, the five most popular health insurance plans are UnitedHealth, Aetna, Anthem, Cigna, and Humana.
Insurance Coverage at Major Urgent Care Centers
Remember that insurance coverage will vary from state to state and is not uniform for every urgent care company. If your insurance company isn’t listed above, make sure to click the link for each urgent care to see a comprehensive list of accepted insurance plans. Before heading to your visit, call to double-check on your insurance coverage, as you don’t want to run into any surprise bills.
Medicare & Medicaid
In addition to most major medical plans, urgent care centers typically accept Medicare and Medicaid as a form of payment. Medicaid covers the cost of emergency care, which includes urgent care. However, their website encourages you to visit a primary care doctor when you can, as copays and coinsurance may be high at an urgent care center or emergency room. These costs increase when you visit an urgent care for a non-emergent situation.
Medicare also covers urgent care, as long as it is not a life-threatening situation that requires immediate medical attention. After your visit, you will be responsible for paying for 20% of the determined Medicare-approved amount. Medicare Part B deductible can be applied here as well. Additional tests and care may come at an additional cost.
Services Covered by Insurance at Urgent Care
Not all services are covered by insurance when you visit urgent care. In general, you will be responsible for paying a copay or coinsurance following your visit. These costs usually range from $20-40 and are paid regardless of the additional services you may need. Benefits will vary for each insurance provider, but you can usually expect to have the initial office visit fee covered.
In addition to your copay or coinsurance, you may face various additional costs for a visit to an urgent care. These costs could cover services such as x-rays, vaccinations, routine tests, and more. The type of insurance you have will determine if your plan will pay for the additional costs.
If you are paying without insurance or your insurance doesn’t cover the services you receive, you will have to pay for additional services out-of-pocket. In the table below, we outline the out-of-pocket costs for various services at two urgent care facilities. Note that prices may vary depending on your location.
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Typical Urgent Care Service Prices
Following your visit, the physician may prescribe you medication. Prescription medications can become very expensive, and insurance doesn’t always cover the total cost of medication.
Below we show the average costs of some common prescription medications. These prices may vary depending on your pharmacy if the drug is generic or brand name, and the prescribed dosage.
Common Prescription Drug Prices
|Drug Name||Average Cost Without Insurance|
A great way to save on prescriptions is through a Mira membership. For only $45 a month, members receive up to 80% off on over 1,000 different medications. Don’t let the cost of the medication deter you from getting better; sign up for Mira today.
Urgent Care Frequently Asked Questions (FAQs)
If you are thinking about going to an urgent care center, you may have some questions. Below are the answers to some common questions about urgent care.
What’s the difference between urgent care and the emergency room?
Urgent care centers specialize in treating ailments that need medical attention but wouldn’t result in death or disability if not treated. Urgent care facilities are perfect for treating a rash, sore throat, stuffy nose, migraine, or more. Emergency rooms are equipped for life-threatening situations, so you should get treatment at an ER if you believe your life is at risk.
If you believe you are experiencing a life-threatening emergency, you should always call 9-1-1 or report to your closest ER. However, visiting an ER for a non-emergent problem could cost much more than visiting a primary care physician or urgent care.
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Can urgent care centers refuse to treat you?
In most situations, urgent care will not refuse service to you if you are in need. Before seeing the doctor, you can discuss costs and insurance with someone at the front desk. If you cannot pay for the services, they can refuse to see you and turn away. However, emergency rooms will not refuse to treat you if you are experiencing a life-threatening emergency. Like emergency rooms, the wait times at urgent care centers may be very long. Therefore, if an urgent care center has a very long wait time, they may need to turn you away.
When should I go to urgent care?
Determining when to visit an urgent care center can be tricky. If you need a physical for school or work, this is an excellent option if your doctor has no appointments available or the office is closed. Urgent cares are also a good place for drug and STD testing. Finally, urgent medical conditions that need to be treated within 24 hours are most often treated at urgent care centers. Some medical conditions that can be treated at an urgent care include:
- Falling down
- Skin infections
- Urinary tract infections
- Severe sore throat
- Eye irritation
- Diagnostic services
- And more
If your medical emergency could result in life or death, call 911 or visit an ER immediately, do not go to urgent care.
Do you need an appointment for urgent care?
No, most urgent care centers do not require appointments to be treated; however, some urgent care facilities take appointments as well. Walk-ins are welcome at most locations, although these increase wait times. Some clinics offer a waitlist online so that you can see how long the wait is and put your name in ahead of time.
Are urgent care doctors less experienced than other doctors?
The doctors that work at urgent care are just as qualified as the ones you may find in an emergency room or at your regular doctor’s office. Urgent care hires various healthcare professionals, including medical doctors, nurse practitioners, physician assistants, registered nurses, and more. There is no specific difference between those working at urgent care and those working at other locations.
Urgent care centers are a great healthcare option when you need immediate, non-emergency care. Most insurance companies cover the cost of urgent care, and most urgent care centers accept all major health insurance plans. You will most likely be responsible for paying a copay or deductible after your visit, as well as additional service fees you may have received. This could include further testing, vaccinations, or prescription medications.
Even with insurance, urgent care costs can add up very quickly. Luckily, Mira can help you out. For just $45 per month, Mira can get you access to low-cost urgent care visits, same-day lab testing, and up to 80% off over 1,000 different prescription medications. Don't break the bank for urgent care - sign up for Mira today.
Talor graduated from Penn State University with a B.S. in Biobehavioral Health, and minors in Spanish and Diversity & Inclusion in May of 2022. She has a passion for health equity and diversity in health. In the future, Talor hopes to work in public health policy reform to help eliminate health disparities. She enjoys reading, cooking, and listening to podcasts in her free time.