Does Medicare Cover Walk

Does Medicare Cover Walk-in Clinics? 

If you’ve ever needed medical care but didn’t have time to make an appointment, you already know how important of a role walk-in clinics play within our healthcare system.

As a Medicare recipient, there may be additional times in the future when you require the care that walk-in clinics provide. Because of this, it’s important to understand the options you have with Medicare when it comes to Medicare insurance coverage and out-of-pocket expenses.

Let’s take a look.

When to choose a walk-in clinic

In the not-so-distant past, a walk-in clinic, also referred to as an urgent care clinic, was often the very first stop for un-insured individuals requiring medical care and not wanting to go to an emergency room. Today, walk-in clinics are there for a wide variety of patients, both insured and un-insured.

It’s important to note that walk-in clinics shouldn’t be used to replace an established relationship with your primary care provider. However, walk-in clinics do allow people to get the immediate care they need in cases where their normal physician is unavailable.

Additionally, most walk-in clinics offer care in the late evenings and on weekends, unlike traditional clinics.

Standard physician services can all be performed in walk-in clinics, including:

• Diagnosing cases of the common cold
• Treat cuts and burns
• Aches and pains
• Rashes and fevers
• Minor injuries

Typically, a walk-in clinic will request information about your primary care provider. This allows them to share information about your visit so that you doctor knows the types of future treatments you may require.

What’s the difference between an emergency room and a walk-in clinic?

Walk-in clinics aren’t designed to treat life-threatening or other severe medical conditions. They have limited diagnostic equipment. Their nurses, doctors and staff are typically only prepared to deal with minor health issues. Complex needs and issues requiring immediate attention should always lead you directly to an emergency room.

An emergency room is almost always connected to a hospital. Patients that experience acute medical needs could quickly be taken into the hospital for immediate care from a team of professionals that are trained to address their specific needs.

Emergency room teams include specialists on call or on duty that can quickly diagnose medical conditions and perform highly advanced procedures to treat an individual’s condition.

In a walk-in clinic, a patient will normally be asked specific questions about symptoms while standing at the sign-in desk. If the patient’s needs exceed the capabilities of the clinic, the patient will be immediately referred to an emergency room.

Is there Medicare coverage walk-in clinics?

If you have Medicare Part B insurance, urgent care centers and walk-in clinics are covered by Medicare as outpatient care. This means that recipients should expect to pay 20% for the coinsurance after their Medicare Part B deductible is met. This is assuming that the facility you went to is certified by Medicare.

 

If you’re looking to reduce your out-of-pocket expenses with your Original Medicare insurance, you may want to enroll in a Medicare Supplement, or Medigap, plan. This may help cover coinsurance or copayment amounts for these kinds of outpatient services. The plans are fully standardized, which means that they will offer identical benefits regardless of the private insurer that offers them. In addition, the Medicare Supplement plans that cover walk-in clinics and urgent care may not be available in all 50 states. 

Medicare Advantage plans are an alternative to Original Medicare. Medicare Advantage plans include the same Part A and Part B benefits, but many plans will offer additional coverage. MA plans may require a recipient to choose their primary care doctors and other specialists from within their approved network.