Health conditions Medicare Your Coverage Options

When you need care quickly, should you use a health clinic?

Written by Diane Archer

Sometimes you may need health care quickly. And, the question becomes where to go for that care. If you can’t reach your doctor, should you get treatment at a health clinic or urgent care center rather than your hospital’s emergency room? In situations that are not life-threatening and when you are not in a crisis, to save time and money, you should consider seeking care at a health clinic or urgent care center.

Is there an FQHC near you? If you do not believe you are in an emergency situation and your doctor is not available to see you, you should consider getting care at a federally qualified health center (FQHC) if there is one near you. These health clinics are administered by the federal government and provide free and low-cost health care. Today, there are nearly 1,400 health centers providing services at 11,000 service delivery sites throughout the US.

Is there a free or charitable health clinic near you? There are more than 1,200 free or charitable health clinics across the US. You might check to see whether there is one near you.

What about a commercial walk-in clinic or an urgent care facility? There are more than 7,500 urgent care centers (where you can usually see a doctor) in the US today. There are also more than 2,800 commercial walk-in health clinics (where you typically see a nurse) located at pharmacies and retail stores like Walmart and Walgreens.

Why go to an urgent care facility or walk-in clinic instead of an emergency room? If you have a common problem, such as a fever, an infection, a stomachache or a deep cut, ask yourself these questions:

  • What does my doctor recommend? Call your primary care doctor to see if he or she is available to see you. It is always best to have your primary care doctor providing your care. If that’s not possible, find out where the doctor recommends you go for treatment.
  • Is there an urgent care center or walk-in clinic near me? If so, can it provide the care I need? And, will my Medicare plan cover my care?
  • What will I pay out of pocket? The cost of your care at a walk-in clinic or urgent care center is likely to be much lower than at the local hospital emergency room or ER. However, if you have traditional Medicare, and supplemental coverage, it should cover your ER care. If you are in a Medicare Advantage plan with a high deductible, your health plan may deny coverage if it decides it was not an emergency. And, even if it covers your care, you will likely save money by avoiding the ER.
  • How long am I willing to wait to get care? The wait for care may be much shorter at a health clinic or urgent care facility than at an ER.

Keep in mind that quality of care you receive is likely to vary significantly depending upon the care you need and the skills of the health care provider delivering the care.

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  • Diane, Just Care Feed is one of the highlights of my week. That said, your obvious bias against Medicare Advantage plans bothers me. I have a chronic condition, severe COPD, and traditional Medicare is of little help with that. But I can’t afford a Supplemental plan. So Medicare Advantage is my best option. Makes me wonder about your motivations sometimes.

    • Hi David, I agree, that the best thing about Medicare Advantage plans today is that you can keep your out-of-pocket costs down if you do not need care or only need care requiring low copays. But, if you need costly care, your out-of-pocket costs can be sky high. Moreover, your costs in a Medicare Advantage plan are likely to go up considerably if Republican lawmakers succeed at destroying traditional Medicare. They will then cut payments to Medicare Advantage plans. Medicare Advantage networks are likely to tighten as well, meaning even less access to doctors and hospitals than today.
      With traditional Medicare you have access to virtually all the doctors and hospitals you need anywhere in the US, which is extremely important to many people with costly and complex conditions. For sure, traditional Medicare needs a catastrophic cap like Medicare Advantage plans. And, an improved Medicare program would have no out-of-pocket costs. Congress should not be allowing health plans to ration care based on ability to pay.

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