Not every health crisis rises to the level of a medical emergency, but if you experience an injury, sudden illness, or if an illness suddenly gets worse, you may need urgent care. Even if your injury or illness is not severe enough to send you to the ER, it can still be serious enough to require care immediately, even when it is outside of normal doctor office hours. Some Medicare recipients hesitate to seek urgent care services because they worry about the costs. Medicare Part B can help pay for services and supplies you get from an urgently needed care facility.

Medicare Benefits and Urgent Care
Medicare provides Medicare recipients with coverage for urgent care, but how do you know if you need urgent care and where do you go?

Incidents that may require urgent care and emergency care may include:

  • Sprains
  • Broken bones
  • Persistent, severe stomach pain
  • High fever
  • Dehydration
  • Vomiting
  • Back pain

If you experience any of the following medical emergencies, you should call 911 or go directly to a hospital emergency room:

  • Serious burns
  • Head injuries
  • Neck or back injuries
  • Chest pains
  • Unexplained seizures or convulsions

Primary Care Physician vs Urgent Care

You might wonder if you should just schedule an appointment with your primary care physician. A primary care physician works by appointment only and some doctors schedule appointments weeks in advance. Your primary care physician is the right choice for managing chronic conditions, regular tests, preventive care, and helping diagnose new but stable changes in your health. Abrupt, serious changes in your health require more immediate care than a primary care physician can reasonably provide.

Urgent care clinics work best for treating the kind of abrupt illnesses or injuries that you can’t wait two or three weeks to see your regular doctor about. Say, for example, that a minor throat tickle has turned into a hacking wheezing cough overnight. If you try to wait to see your regular doctor about it, the condition might turn into something that will land you in the emergency room. Urgent care treatment can get you the help you need before the condition can escalate.

Urgent Care Costs
Medicare Part B (Medical Insurance) helps cover the cost of urgently needed care that is not a medical emergency. You will pay 20% of the cost for services, and the Part B deductible will apply. In the event that you visit an outpatient urgent care clinic in a hospital, you may also be charged a copayment by the hospital itself. Urgent care clinics specialize in treating sudden injuries or illnesses that don’t rise to the level of a medical emergency but typically need treatment within about 24 hours.

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