Does Medicare Cover Federally Qualified Health Center (FQHC) Services?

Federally qualified health centers (FQHCs) and the services provided are covered under Medicare – specifically Medicare Part B.

An FQHC can offer a variety of outpatient and primary care and, like most treatments and services available through Original Medicare, is covered if deemed a medical necessity.

Covered visits must be face-to-face and take place with an FQHC practitioner.

Medicare will not cover your FQHC visits if they occur at an inpatient or outpatient hospital department or a facility that excludes those types of services.

Medicaid beneficiaries should also be eligible to receive treatment and services at FQHCs.

Medicaid is an assistance program designed to help you receive healthcare coverage if you meet certain requirements, like having a low income.

Federally qualified health centers are also covered through Medicare Part C.

Medicare Advantage plans include everything under Original Medicare, so an FQHC visit would also be covered.

Medicare Part B pays for 80 percent of the cost of any services you receive at a center – which means you are responsible for the remaining 20 percent.

You do not have to pay a deductible or coinsurance.

Preventive services are also available through an FQHC at no cost to you. Additionally, there are discounts available if your income is limited.

Federally qualified health centers are in rural and urban areas. These centers are meant to help underserved communities and populations as a low-cost way to receive healthcare.

According to 2018 United States National Library of Medicine study, the number of FQHCs has increased by more than 80 percent through the previous decade.

Your FQHC care options range from physician services, transitional care and chronic care management.

If you have diabetes or renal disease, you may also be eligible for outpatient diabetes self-management training and medical nutrition therapy through an FQHC. Check with your healthcare provider or local health center to determine what other services might be available to you.

The U.S. Health Resources and Services Administration offers a map to easily locate FQHCs near where you live.