Best Small Emergency Rooms That Take Medicare (2021)

If you require medical services and have Medicare Part B insurance, you should not have any issues finding small emergency rooms that take Medicare. Fortunately, the majority of small emergency rooms are part of the Medicare emergency room fee schedule, and most urgent care facilities take Medicare insurance as well.

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UPDATED: Nov 3, 2021

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Overview

  • You can easily find affordable small emergency rooms that take Medicare insurance
  • Most urgent care facilities also accept Medicare coverage
  • Even with Medicare, you may need to pay an emergency room (ER) copayment plus additional diagnostic fees

Medicare is a federally provided health insurance program for Americans aged 65 and older. There are many small emergency rooms that take Medicare insurance, but you’ll likely still pay a copayment.

Below, learn how to use your Medicare coverage when you visit a small emergency room.

After learning about small emergency rooms that take Medicare insurance, remember to enter your ZIP code into our free tool above to compare supplemental Medicare quotes from the top insurance companies near you.

Are there small emergency rooms that take Medicare?

Medicare insurance typically covers a portion of emergency room visits, as long as you’ve enrolled in Medicare Part B coverage.

Most people have at least Medicare Part A and B, which is referred to as Original Medicare.

If you’re receiving Social Security benefits when you turn 65, you’re automatically enrolled in Medicare Part A, which covers short-term inpatient care, hospital visits, hospice, and home care.

As long as you’ve paid 10 years of Medicare taxes, then Medicare Part A is free. However, you also have the option to sign up for Part B coverage when you turn 65.

Medicare Part B assists with the following services:

  • Doctors visits
  • Medically necessary services and supplies
  • Preventative health care
  • Ambulance services
  • Durable medical equipment
  • Mental health coverage
  • Some outpatient prescription medications

Rates for Part B coverage starts around $150 per month.

In addition, if you don’t enroll in Part B coverage as soon as you’re eligible, you’re subject to a 10% penalty for every 12 months the policy is delayed.

Technically, only Medicare Part B helps with emergency room visits.

However, you can purchase supplemental coverage from private companies that may provide additional protections, known as Medigap and Medicare Advantage.

The good news is that most emergency rooms, both large and freestanding emergency centers, accept Medicare insurance.

Does Medicare cover urgent care costs? Yes, if you carry at least Original Medicare, then a portion of your urgent care visit should be covered.

Does urgent care take Medicare? Some urgent care facilities also accept Medicare, but according to the Centers for Disease Control and Prevention (CDC), urgent care is not an ER service. Urgent care may even be billed differently by your insurance company, depending on state laws where you live.

Emergency room visits that happen out of the country are not usually covered by Medicare; however, there are some rare exceptions.

Ultimately, your small emergency room options vary drastically depending on where you live or where you are at the time of the emergency.

But most ER facilities are part of the Medicare emergency room fee schedule.

Never hesitate to ask if the facility is in the Medicare network if you’re uncertain. You can also verify what small emergency rooms are in-network by looking on the Medicare website.

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How much does a small emergency room visit cost with Medicare insurance?

The cost of your small emergency room visit, even with Medicare, varies depending on your specific treatment, follow-up needs, and the type of Medicare you use.

The average emergency room visit costs over $2,000.

Variables like what other insurances you have, what the doctor you choose charges for the services, the type of facility you use, and where you’re getting tested impact your out-of-pocket obligations.

Your costs with Original Medicare for emergency department services include a copayment for each emergency visit as well as a copayment for each hospital service. You’re also responsible for 20% of the Medicare-approved amount for the doctor services plus the deductible associated with your Part B coverage.

But if your doctor admits you to the same facility for an associated condition within three days, then you do not need to pay the copayment again, as it’s considered part of your inpatient stay.

If you use Medigap or Medicare Advantage, your private insurance company may offer further financial assistance for your small emergency room visit. So you can potentially save even more money by comparing insurance plans.

What You Need To Know About Small Emergency Rooms That Take Medicare

Fortunately, most small emergency rooms take Medicare insurance. The Medicare website even lets you search for emergency rooms and urgent care facilities by state.

But you can also ask a facility directly if your insurance is accepted.

What’s the difference between an emergency room versus urgent care? Urgent care is for minor conditions that are not life-threatening but still can’t wait, like:

  • Sprains
  • Strep throat
  • The flu
  • Minor burns

Emergency rooms, even small ones, are for life-threatening or emergency situations, including chest pain, high fever, loss of vision, or difficulty breathing.

Now that you know Medicare does cover urgent care visits, enter your ZIP code into our free comparison tool below to compare rates from the top supplemental Medicare insurance companies near you.

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Enter your zip code below to view companies that have cheap insurance rates.

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