Medicaid, Medicare or Private Insurance: What’s Covered for Urgent Care?
Before an emergency strikes, it’s important to know your insurance plan and what options it covers. Instead of going to the ER and risking an expensive medical bill, your insurance may cover a visit to an urgent care clinic. However, that may not always be the case.
Medicaid, Medicare or Private Insurance For Urgent Care?
Are you savvy on your insurance plan and what it covers? Don’t assume you’re covered. It’s important to research the available healthcare options and how they work for you and your needs.
Below we’ve outlined Medicaid, Medicare, and private insurance plans -- and if you’re eligible for urgent care services.
What is Medicaid?
Medicaid, along with the Children’s Health Insurance Program (CHIP), is the single largest source of healthcare coverage for low-income adults, children, pregnant women, elderly adults and people with disabilities.
In order to qualify for Medicaid, individuals must meet certain eligibilities by income and other state-determined qualifications. Low-income families, pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are mandatory groups covered by Medicaid.
Is Medicaid Accepted at Urgent Care Clinics?
Yes, most urgent care clinics accept Medicaid. However, it’s important to note that some urgent care clinics may not take Medicaid; therefore, it’s crucial to call in advance to make sure.
According to Alabama Medicaid, “Medicaid recipients may be asked to pay a small part of the cost (co-payment) of some medical services they receive. Medicaid pays the rest. Providers cannot charge any additional amount other than the co-payment for Medicaid-covered services. Co-payments range from $1.30 to $3.90 for each visit, and between 65 cents and $3.90 for prescription drugs and medical supplies and appliances. When a Medicaid recipient is admitted to the hospital, the co-payment is $50.”
The Differences Between Medicaid and Medicare
Unlike Medicaid, Medicare is a federal health program for those 65 and older, certain younger people with disabilities, and people who require dialysis for their End-Stage Renal Disease (ESRD).
Medicare Part B for medical insurance covers certain outpatient care, preventive services, medical supplies and specific doctors’ services.
Urgent care typically falls under the Medicare coverage care category of emergency department services. Medicare Part B covers all emergency services, including care provided for injuries, illnesses or rapidly-worsening conditions.
Private Insurance, Covered for Urgent Care
Unlike Medicaid and Medicare that requires certain eligibility for care, private insurance healthcare plans are available for most Americans. Those who do not have employee-sponsored health insurance can sign up for coverage in the Healthcare.gov Marketplace and choose the healthcare plan that best matches their coverage needs and income. After selecting your coverage, your provider will supply you with the necessary documentation to determine if you qualify for urgent care.
Although nearly all urgent care clinics take private insurance, please make sure before you visit that your coverage is in-network; otherwise, you could be paying more for the same quality of care. Most urgent care clinics answer insurance coverage questions on their website, but if not, you can simply give them a call.
Most Importantly, Do Your Research!
No matter what insurance you have (or if you’re paying for service out-of-pocket), it’s absolutely critical that you do your research beforehand, so you’re not at risk of spending more money than necessary.
Additionally, we encourage you to weigh your options when choosing to go to an ER or urgent care for your needs. Although an urgent care clinic can not replace emergency services for life-threatening conditions, they are much less expensive and time-consuming for effective, quality care.
Choosing Crimson Care As Your Care Provider
Crimson Care Skyland accepts Medicaid, Medicare and most private insurance. Crimson Care Skyland offers comprehensive, compassionate care for the Tuscaloosa area, including an Occupational Health Center as well as Tuscaloosa’s first urgent Mental Health Center.
Give us a call to discuss your coverage options and what you’re eligible for. We offer care seven days a week, so you can feel better, sooner.
Learn about your Medicaid, Medicare or private insurance options with Crimson Care in Tuscaloosa, AL.
Dr. Ramesh Peramsetty -- along with his entire Crimson Care team -- is committed to making medical services convenient and accessible. The clinic offers three Tuscaloosa locations: Skyland, Veterans Memorial and McFarland. All locations offer extended weekday hours and one-stop treatment services including medical care, x-rays, lab work, and prescription dispensing. Crimson Care also offers digital access through its online patient portal. Request prescription refills, complete any necessary patient forms online, review your medical records at any time, and even pay your bill. 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.