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I’m sick! Will my insurance cover a trip to an urgent care facility?

Updated: Jun 27, 2023

Not feeling your best? Can’t get an appointment for two days at your primary care doc? Then it’s time to roll on up to an urgent care facility. But how do you know how much it will cost, and whether or not they will take your insurance?

We’ve put together an explanation of the different types of insurances that are out there, and then we talk about how each type of insurance might apply to a visit to an urgent care facility.

Types of insurance for urgent care

It’s important to understand the details of the type of insurance you have, so you can make a determination about what’s likely to be covered, and what’s not. Insurance carriers vary by type and by state, so you’ll want to be certain you know what to expect. A call to your insurance carrier is never a bad thing.

Medicaid: what is it, and how does it work?

Do you have a limited or low fixed income? Then Medicaid was designed for you. It is estimated that one out of five people in the US have Medicaid as their primary source of insurance, so it’s pretty common.

The great thing about Medicaid is that you have many of the same coverage types as people who have private health insurance. Usually, you qualify for Medicaid if you have an income below 100% of the federal poverty level.

Medicaid even covers your dependents. The average monthly cost of Medicaid is largely dependent on your income and varies by state, but it can be as low as $0.

Medicare: how is it different from Medicaid?

The thing to remember:

Medicaid is based on income

Medicare is based on age

Both Medicare and Medicaid are public health insurance programs, but they differ in many ways. For example, you are only eligible for Medicare if you are 65 years of age or older; that said, you may be eligible for Medicare if you have experienced certain types of disabilities. In fact, there are some cases where you might be eligible for both.

Can I use Medicaid at an urgent care clinic?

Fortunately, most of the time, you can use Medicaid at an urgent care clinic. It’s always best to check with your individual carrier, however, just to make sure. Your urgent care clinic can also advise you on this.

It may be entirely covered, or there may be a small co-pay. Luckily, even if you have a small co-pay, urgent care clinics cannot charge you for anything over that co-pay, so you’ll at least know what to expect to pay out of pocket when you get there if this is the case.

What about Medicare? Will I be covered at an urgent care clinic?

Medicare contains a category called “emergency services,” and it is likely that this category will cover your trip to a clinic, so long as you have Medicare Part B (for more information about the different parts of Medicare you may elect to get coverage for, click here.)

What is private insurance? How do I know if that’s what I have?

If you happen to be a student at the University of Alabama and you’re wondering what type of insurance you carry, you might ask your parents or a school advisor. Really, it all boils down to this: if you do not have coverage through a government program yet you have an insurance card, you have private health insurance.

It is very likely that if you have private health insurance, your trip to the urgent care clinic will be covered. That said, if you’re unsure whether or not the visit will be covered or even how much of a co-pay you might expect, call the number on the back of your insurance card and just ask. Five minutes of proactivity can save you from any unexpected surprises once you’re there.

Now - some insurance companies specify that you must visit a healthcare provider that is “in network.” This means that they have a list of providers who are part of their network with which they have negotiated a discount. This is another reason to reach out to your insurance company - make sure the urgent care clinic you’re about to visit is “in network.”

Ok, I’m covered. Why should I visit an urgent care facility?

Urgent care facilities like Crimson Care are an invaluable cog in the healthcare wheel. Perhaps you’re new in town, and you haven’t found a primary care doctor yet. Or maybe you suddenly feel very sick, and your doctor’s office can’t work you in for a couple of days. Or maybe you have an injury that requires medical attention but is not bad enough to have to go and wait in a hospital ER. These are all great reasons to visit an urgent care facility!

Although they cannot take the place of emergency services you might need for life-threatening injuries or illnesses, urgent care facilities can treat you for many different healthcare situations. A cold, the flu, burns, breaks, sprains, earaches, vomiting, allergies, sinus problems - the list just goes on and on. You don’t have to have an appointment, so you have the convenience of just walking right in. In addition, physicians at urgent care facilities are just as qualified and caring as doctors at private or hospital physician practices. At Crimson Care, our average wait time is less than an hour. We are even open on weekends when most doctor’s offices are closed. Moreover, we’re open until 7:00 pm!

The convenience of walking right in and being seen, weekends and evenings. Being covered by your insurance. Not sick enough to go to the hospital but sick enough to be seen ASAP. All of these and more are reasons why urgent care clinics can be your best friend the next time you get sick.

Understand all urgent care services available at Crimson Care in Tuscaloosa, AL.

Dr. Ramesh Peramsetty -- along with his entire Crimson Care team -- loves working with urgent care needs in the Tuscaloosa AL community. We actually have three different clinics in convenient locations throughout Tuscaloosa: Crimson Care Skyland, Veterans Memorial, and First Care on McFarland. All sites offer extended weekday hours and one-stop treatment services, including medical care, x-rays, lab work, and prescription dispensing. Crimson Care has a patient portal for viewing your electronic medical records and is a state-of-the-art medical facility.

Check us out today on our website, or give us a call today at Crimson Care Veterans: (205) 507-1100, Crimson Care Skyland: (205) 507-1119, or First Care: (205) 349-2323.



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