Health Insurance

The Cost of a Doctor Visit Without Insurance

Jacqueline Slobin25 May 2021

The Cost of a Doctor Visit Without Insurance

The cost of a doctor visit depends on whether you have private insurance, Medicare, Medicaid, or no insurance. If you do not have insurance, the cost of a doctor visit is typically between $300 and $600, but prices can vary depending on several factors such as lab tests, where you seek care, and procedures done at the visit. 

If you do not have insurance or have a high deductible plan, Mira is a great option to help you get coverage for the care you need. For only $45/month, Mira members can get access to urgent care, lab tests, and prescriptions for a low price. You can start using Mira as soon as you sign up and do not need to meet a deductible. 

The Total Cost of a Doctor Visit 

The price that you pay to see a doctor will depend on whether you are covered by insurance and what type of insurance you have. In this section, we outline how the cost of a doctor visit varies if you have private insurance, Medicare, Medicaid, or do not have insurance. 

  • Insurance: If you have private insurance, the price that you pay to see a doctor will depend on several factors, including the type of plan you have, your copay, co-insurance, and deductible. In general, the copay to see a primary care physician is usually between $15 and $25, while the copay to see a specialist may be between $30 and $50. 
    It is important to note that many services will not be covered by your insurance until you meet your deductible. Therefore, you may need to pay the full out-of-pocket prices for services until you meet your deductible. Some services, however, may still be covered before you meet your deductible depending on your insurance plan. 
    Even after you meet your deductible, if your doctor orders lab tests from an out-of-house lab, you may be charged for those tests directly from the lab. It is also important that you go to in-network providers, as some insurance plans will charge higher rates or not cover out-of-network providers.
  • Medicare: Medicare Part B covers services such as outpatient medical care. Medicare does not use copayments, but rather you need to meet a deductible and then pay a set co-insurance, or percentage of the cost to seek care. Individuals who have Medicare part B generally have to pay about 20% of the cost of services, such as seeing a doctor.
  • Medicaid: The cost of going to the doctor if you are covered by Medicaid varies by state. In New York, individuals covered by Medicaid will be required to pay 20% of what the state pays for both inpatient and outpatient care. Some individuals, such as children or pregnant women, may be exempt from paying the Medicaid copayment. Some services, such as emergency room visits, may also be exempt from copayments.
  • No insurance: Without insurance, the cost of going to a doctor typically ranges from $300 to $600. This price will vary depending on whether you see a specialist, if lab tests are completed, and if any procedures are done. If you do not have insurance, Mira may be a great option for you. For only $45/month, a Mira membership can help you access prescriptions, lab tests, and doctor’s visits for a low price. With a Mira membership, you will only need to pay $99 to go to see a doctor at urgent care.

Where to See a Doctor If You Do Not Have Insurance 

If you do not have insurance, there are several places that you can seek care when needed. 

  1. Community Health Clinics: There may be clinics near you that provide free or low-cost health services, such as preventative care, vaccinations, or health screenings. You can search for free or community health clinics in your area by using FreeClinics.com.
  2. Urgent Care: You can also see a doctor and get many services done at urgent care facilities. Some urgent care facilities are walk-in and others you can make an appointment on their website. In general, most urgent cares charge a visit fee of about $100-$200 to see a provider in addition to other fees for the services you receive. With a Mira membership, you can go to urgent care facilities for only $99.
  3. Telehealth: Many doctors and companies are now offering telehealth services, which may be a more convenient and less expensive way to seek care. Sometimes after a consultation, your doctor can prescribe medication or give you medical advice. Some conditions, however, may require you to seek care in person after your telehealth call. Some companies, such as Teladoc, MDLive, and Doctor on Demand offer online consultations that range from $65 to $260.
  4. Doctor’s Office: You can also still seek care at a primary care physician or specialist’s office. However, be sure to call in advance to ask the office what their policy and pricing are for patients who do not have insurance.
  5. Emergency Room: If you are experiencing an emergency situation, you should always call 911 or go to your nearest emergency room. Regardless of your insurance status, you will be able to get treatment. However, if you have a non-urgent medical condition or just need a routine visit, going to urgent care or any of the other options above will likely be much less expensive.  

How to Save Money at the Doctor Without Insurance 

Going to the doctor can be expensive, especially when paying without insurance. Below are some tips and tricks that you can keep in mind to help save money when going to the doctor. 

  • Shop around before choosing a doctor you would like to go to. The price of the same service can vary greatly depending on the doctor’s office you decide to visit, so it is important to call multiple places and ask for their prices when possible.
  • Tell your doctor that you do not have insurance and ask if they offer any discount rates. Some providers have discount rates for individuals who do not have insurance and can give you a discount if you pay in advance or pay in cash. However, most doctor’s offices do not advertise this, so you should always ask.
  • If you are getting a prescription medication, you can ask your doctor if they have free samples that they can offer you. You should also always ask if your doctor can prescribe the generic version, as they are typically cheaper than the brand name. In addition, a Mira membership can help you access discount codes to use on your prescription.
  • You can also set up a savings account to put aside a certain amount of money each month to pay for doctor visits and other health care expenses. This can help you manage your money and help ensure that you have enough money to pay for your health care needs each month. If you have a high deductible plan then you may qualify for a health savings account (HSA), which allows you to put pre-tax money for medical expenses away.
  • Consider getting a Mira membership. Mira is an alternative to health insurance that offers its members low-cost urgent care, prescriptions, and lab tests for only $45/month. Mira can help ensure that you are able to seek care when you need it at a low price.

Costs of Doctors Visits Frequently Asked Questions (FAQs)

Will a hospital treat me if I do not have insurance? 

Under the Emergency Medical Treatment and Active Labor Act, hospitals are required to provide care to all individuals in an emergency situation, regardless of insurance status or ability to pay. While you will be treated if experiencing an emergency, you will likely still be responsible for paying your bill after you have recovered. 

Doctors’ offices, however, are not covered by this act. Therefore, if you are unable to pay and you are not experiencing an emergency situation, you may be denied care at a private doctor’s office. 

What affects the cost of a doctor's visit? 

There are several factors that may affect how much your pay when seeking care at a doctor’s office. Some of these factors include: 

  • Where you seek care
  • If you are going to a specialist
  • If you have insurance
  • What services you receive at the doctor’s office
  • If you will need any prescription medications
  • If you get lab tests done and whether those tests are done in-house
  • The severity of the condition being treated

How can I figure out the cost of seeing a doctor at different offices? 

While some urgent care facilities and doctor’s offices post their prices for visit fees and various services on their website, most do not. If the prices are not posted online, you can call the doctor’s office or urgent care directly. 

You should ask what the price is for a visit fee and the additional charges that may be associated with treating the condition or symptoms you have. You probably will not be able to get an exact price before you see a doctor, but calling in advance can help you get an estimate of how much you may need to pay. 

Here are some questions you can ask when calling to inquire about prices: 

  • How much is a visit fee if paying without insurance?
  • How much does this service cost? Is this price included in the visit fee or added to the visit fee?
  • Does the price vary depending on which provider I see at this practice?
  • How much do lab tests typically cost?
  • Are there any other fees that may be associated with my visit?

Bottom Line 

The cost of a doctor visit can be expensive, especially when paying without insurance. If you do not have insurance, you can seek care through community health clinics, urgent care facilities, telehealth, doctor’s offices, and hospitals. While the price of seeing a doctor without insurance is typically between $300 and $600, the price will depend on where you seek care and several other factors. 

With a Mira membership, you can see a doctor at urgent care for only $99. You can start using care as soon as you sign up and have peace of mind that you can always make an appointment to see a doctor for a low price. 

Millennials are leaving health insurance carriers to join the new "CostCo" of healthcare.

"My insurance premiums went up 30% this year. My husband and I switched to Mira and never looked back," said Danna - Brooklyn, NYC