Christian Simmons, writer and researcher for RetireGuide
  • Written by
    Christian Simmons

    Christian Simmons

    Financial Writer

    Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.

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    Lee Williams
    Lee Williams, senior editor for

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine,, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

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    Aflak Chowdhury
    Aflak Chowdhury

    Aflak Chowdhury

    Medicare Expert

    Aflak Chowdhury is a Medicare expert and independent insurance broker specializing in group health insurance. He has worked for major providers including Humana and Principal Financial Group and today works mainly in the small group market.

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  • Published: June 22, 2021
  • Updated: October 20, 2023
  • 4 min read time
  • This page features 8 Cited Research Articles
Fact Checked
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A licensed insurance professional reviewed this page for accuracy and compliance with the CMS Medicare Communications and Marketing Guidelines (MCMGs) and Medicare Advantage (MA/MAPD) and/or Medicare Prescription Drug Plans (PDP) carriers’ guidelines.

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How to Cite's Article

APA Simmons, C. (2023, October 20). Does Medicare Cover Urgent Care Visits? Retrieved May 17, 2024, from

MLA Simmons, Christian. "Does Medicare Cover Urgent Care Visits?", 20 Oct 2023,

Chicago Simmons, Christian. "Does Medicare Cover Urgent Care Visits?" Last modified October 20, 2023.

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RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

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Urgent Care Coverage at a Glance
Medicare PlanUrgent Care Coverage
Part A (Inpatient)N/A
Part B (Outpatient)Covers 80% of urgent care visit services and tests after you have reached your Part B deductible. You will also owe copayments for each service received.
Part C (Medicare Advantage)Costs for urgent care visits vary by plan.
Part D (Prescription Drugs)Yes
Supplemental InsuranceCan help cover out-of-pocket costs related to urgent care visits. Coverage varies by plan.

Medicare Coverage for Urgent Care Visits

Urgent care visits offer access to immediate medical attention for unexpected injuries or illnesses. Medicare will cover these visits and any treatment or procedures you receive during your visit under Part B.

Common Injuries or Conditions Worth an Urgent Care Visit
  • Bleeding from a cut
  • Cough
  • Fever
  • Minor broken bones or fractures
  • Rashes
  • Urinary tract infections
  • Vomiting or diarrhea

Urgent care clinics also offer other Medicare-covered services outside of immediate illness and injury. For example, you can receive annual physicals and X-rays at clinics, as well as vaccine and immunization shots.

Remember, an urgent care visit is for minor, unexpected medical conditions. Anything more serious would require a trip to the emergency room.

Medicare also covers emergency department services for these situations.

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Expected Costs of Urgent Care Visits

If you have Original Medicare — Part A and B, collectively — then 80% of the cost for treatment and services received at an urgent care clinic will be covered.

With Part B, you will have to meet a deductible before coverage begins. After the deductible has been met, you pay 20% of the Medicare-approved cost.

You will also have to pay a copayment if you receive care in a hospital outpatient setting.

Urgent care visits are also covered through a Medicare Advantage plan since they include everything covered in Original Medicare.

Medicare Advantage plans also include additional benefits and coverage and what is offered in Part A and Part B.

Check with your plan provider to learn about any expanded coverage available related to urgent care trips.

As a result of your urgent care clinic, a doctor or healthcare provider may recommend a prescription drug to help you recover from your injury or illness.

Prescription drug coverage is not available through Original Medicare — but is covered by Medicare Part D as an optional benefit through private insurers.

Medicare Reimbursement for an Urgent Care Visit

As with most Part B coverage, your urgent care visit will only be covered if the clinic you visit and the doctor or healthcare provider who treats you are enrolled in Medicare.

It is important to inquire about this before you receive any services to make sure that you are covered. If not, then you will have to pay out-of-pocket for any treatment you receive.

However, you can file a Medicare reimbursement claim later to get your money back even if the clinic is not enrolled.

When filing the claim, you will need to include the bill from the doctor or clinic as well as a letter explaining your reasoning for wanting reimbursement. You can find the form to fill out here.

You must file the claim within a year of when you received the services in question.

If you have a Medicare Advantage plan, then you do not need to file a claim.

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FAQs About Medicare's Coverage of Urgent Care Visits

How do you filter for urgent care facilities that accept Medicare?
To filter a search for urgent care facilities that accept Medicare, go to and click the “Find Providers Near Me" button. Choose the “Doctors & Clinicians” option and fill out the “My Location” box. Under “Name & Keyword,” type in “Urgent Care.”

This will give you a list of urgent care facilities near you. Not all the providers on this list may accept Medicare. Check with them first.
Will Medicare pay for me to go to the ER vs. urgent care?
Medicare covers both ER visits and visits to urgent care facilities. You should only go to an emergency room if you are facing a life-threatening condition needing immediate attention. If you need medical care for a non-life-threatening illness or injury and you can’t get an immediate appointment with your doctor, consider urgent care.
Does TRICARE for Life cover urgent care?
TRICARE for Life covers urgent care. It defines urgent care as medically necessary care or services for an illness or injury that requires medical attention within 24 hours, but won’t result in disability or death if it doesn’t get immediate attention. If you have both TRICARE and Medicare, each may pay a portion of your urgent care services.

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Last Modified: October 20, 2023

8 Cited Research Articles

  1. (2021.) TRICARE For Life Handbook. Retrieved from
  2. ‌NH HealthCost. (2018, June 15). What are urgent care centers? Are they less expensive? Do I need a referral? Retrieved from
  3. Idaho State University. (2016, June 1). Immunization and Vaccinations Available at Urgent Care Clinics. Retrieved from
  4. U.S. Centers for Medicare & Medicaid Services. (2015, April 10). CMS Manual System. Retrieved from
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Emergency department services. Retrieved from
  6. U.S. Centers for Medicare & Medicaid Services. (n.d.). How do I file a claim? Retrieved from
  7. U.S. Centers for Medicare & Medicaid Services. (n.d.). Urgently needed care. Retrieved from
  8. (n.d.) Part B costs. Retrieved from