When a minor health concern, like an itchy rash or bug bite, requires urgent care and your primary physician is booked out, urgent care may be the perfect solution. But you might be curious as to the cost associated with such visits without insurance coverage.
Answers can differ depending on whether your chosen urgent care clinic participates with your health insurance plan and has met its deductible.
Costs based on SolvClearPriceTM
Urgent care visits can vary in cost depending on which clinic and health insurers accept your policy. On average, however, urgent care visits cost less than visiting a primary care doctor; however, without coverage it could still prove expensive.
Urgent care clinics offer a range of services, from suturing wounds and setting broken bones to vaccinations, blood tests and physical exams. Most locations are open late into the night seven days a week and can treat most minor illnesses and injuries more affordably than an emergency room visit.
Of course, many people see their primary care physicians for routine check-ups; however, when something urgent arises that cannot wait until tomorrow or their physician’s office opens. Many who visit an emergency room for non-life threatening conditions are later surprised to learn they could have saved both time and money by seeking care at an urgent care clinic instead.
Urgent care and primary care can both serve as effective alternatives to an emergency room visit, however they vary significantly when it comes to the types of services provided. If you’re confused as to which option best fits your condition, here are a few guidelines to help make the correct selection:
Costs based on your insurance plan
Urgent care provides higher levels of medical treatment than your average doctor’s office, typically employing physician assistants, nurse practitioners and nurses as healthcare providers. Urgent care centers typically operate seven days a week with more flexible hours than emergency rooms.
Cost of urgent care clinic visits will depend on your insurance plan, with most health plans offering discounted rates with urgent care providers who participate in their network. Since these discounted rates may be lower than full rate charges by an urgent care clinic, it’s essential that you check if the facility you plan to visit falls under this umbrella of coverage.
Apart from your negotiated rates, additional expenses may include copays and deductibles that may add up quickly – especially if visiting an urgent care center that’s out-of-network. If purchasing health insurance coverage instead, try finding a plan with low deductibles and high maximum coverage to minimize these additional costs.
If you have health insurance, using the online tools provided by your insurer to find an urgent care center within your network should not be difficult. These tools will show which urgent care centers accept your policy as well as the types of services they cover.
Make sure to reach out to an urgent care center before scheduling an appointment to see if they accept your health insurance plan; some centers only state “accept”, which differs from in-network coverage. For a cost-effective policy check out the Affordable Care Act homepage.
Solv estimates the average visit to an urgent care facility without insurance costs $100-$200 without lab work or additional treatments, however costs could increase significantly depending on your individual situation. You could save money by signing up for an urgent care membership; Mira offers such memberships for $99 that provide access to urgent care facilities, virtual care and lab testing as part of its membership benefits.
Costs based on the facility
Cost of urgent care visits without health insurance varies significantly based on where and what treatment is rendered, but typically includes a base fee (typically around $100), lab tests, x-rays and copay/coinsurance charges. With health coverage you may be able to avoid these additional costs by paying only your co-pay or coinsurance payment.
Finding affordable urgent care prices starts by seeking facilities within your health insurance provider’s network – often known as preferred providers. Even if you are uninsured, check your provider to make sure they accept your plan. Some urgent care centers may also charge a facility fee of $25-$300 which aren’t usually covered by most health plans.
Urgent care offers patients who require immediate healthcare but can’t wait for their PCP to see them a great option for treatment. Staffed by physicians, nurse practitioners and PA-Cs seven days a week – often much cheaper than an emergency room visit
Studies show that visits to an emergency room (ER) are 10 times more costly than visits to an urgent care center, prompting hospitals and insurers to implement strategies designed to divert patients away from using emergency rooms.
Some urgent care centers offer more expansive staffs than others, and those with higher overheads will cost you more. Such facilities may include those embedded within a hospital, grocery store, pharmacy or senior care facility with large parking lots and convenient corner locations as well as landscaping costs that add up over time. Furthermore, extra charges such as staff salaries can add significantly.
Without insurance, urgent care can be expensive. But Mira offers affordable memberships that cover urgent care costs while also giving access to virtual care and lab testing – you can even begin using it immediately since there’s no deductible requirement!
Costs based on your condition
Cost of urgent care without health insurance varies widely depending on your condition and urgency of care needed. For instance, injuries requiring x-rays or minor procedures typically have higher expenses than treating something more minor like fever or strep throat. Furthermore, clinic location has an effect; larger urban urgent care centers will have higher bills than smaller pharmacies offering urgent care services in small clinics with affordable fees; purchasing and maintaining expensive medical equipment add to overall visit expenses as well.
Notably, urgent care costs tend to be significantly less expensive than hospital emergency room visits; however, you should never compromise your health needs due to financial considerations of treatment. If the cost of urgent care exceeds what you can afford, try working out a payment plan with them instead.
If you have health insurance, be sure to inquire if the urgent care facility participates in your insurer’s network. Simply saying, “we accept” may only cover part of the visit. Additionally, before seeking medical services make an inquiry with your insurer to find out which urgent care providers they cover.
Cost of urgent care visits also depend on your deductible or coinsurance payment amounts, with most insurance plans having an out-of-pocket deductible you must meet before they will cover any visits made out-of-network. Coinsurance requires you to pay a percentage (e.g. 20%) until reaching an annual out-of-pocket maximum limit.
