Is Urgent Care Covered by Health Insurance?

When patients experience a sudden onset of symptoms such as a sore throat or minor trauma, they often wonder if they should visit their primary care physician, head to urgent care, or go directly to the emergency room. These three different health care options can involve drastically different price tags.

Urgent Care Visit Cost

Urgent care visit costs are on average relatively low compared to an emergency room visit. An urgent care visit usually costs about $150. Urgent care is a great option for patients who require same-day or immediate treatment for an injury or illness which is not life-threatening. Patients who find themselves needing care on a weekend or who are unable to get an appointment with their primary care provider, may find that urgent care is the best option.

Urgent care centers are often open later in the evening and on weekends. In addition, most urgent care centers do not require that you make an appointment prior to your visit. Although, making an appointment online in advance can help ensure you are able to be seen as soon as possible or wait at home, if needed.

In cases where the staff is unable to treat you or suggest that your condition is more serious, they will typically encourage you to go to the emergency room for treatment. There are other options such as virtual care, or E-visits, which can allow patients to receive care for some common conditions without even leaving the house. The provider can help provide you with a treatment plan or prescription, if needed. Patients often don’t need to schedule an appointment in advance in order to be seen the same day.

Urgent Care and Emergency Room Costs

In regards to the expenses, an urgent care visit typically costs far less than a trip to the emergency room. The cost for an ER visit can vary drastically and cost anywhere from about $600 for a minor issue to more than $3,000 for a serious issue or injury.

Even for patients who have health insurance, they can expect to pay a high out-of-pocket expense before your deductible is met. Based on information from debt.com, the cost for treating a non-life-threatening issue at the emergency room can cost up to five times more than treatment from an urgent care center.

It may also take longer to be seen by a doctor in an emergency room compared to an urgent care. In an emergency room setting, patients who have more severe issues are given the priority and seen first.

Does Insurance Cover Urgent Care Visits?

Yes, most insurance companies have coverage for both Emergency Department visits, and Urgent Care visits, pending your deductible plan. At Heritage Urgent & Primary Care, you do not need to worry about a high copay and cost, as all visits are billed under Primary Care services. Be sure to call ahead or visit the center’s website to determine what insurance they accept.

It is important to be familiar with your health insurance plan and know your options for emergency situations before they happen.

More on Urgent Care : Is a Minute Clinic the Same as Urgent Care?