Insurance Coverage for Urgent Care
Health insurance plans generally cover urgent care as part of outpatient medical services. Coverage details vary by plan.
What's Typically Covered
- Doctor/provider evaluation
- Diagnostic tests (X-rays, lab work)
- Minor procedures (stitches, splints)
- Prescriptions (covered under pharmacy benefit)
Typical Costs by Plan Type
| Insurance Type | Urgent Care Copay |
|---|---|
| HMO | $25-$50 |
| PPO (in-network) | $35-$75 |
| PPO (out-of-network) | $75-$150+ |
| High-deductible | Full cost until deductible met |
| Medicare | 20% coinsurance |
| Medicaid | $0-$5 |
How to Verify Coverage
- Check your insurance card for urgent care copay
- Call the urgent care center with your insurance info
- Use your insurance company's provider directory
- Ask about in-network vs out-of-network rates