Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Dec 5, 2021

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The Lowdown

  • Medicare Part B will cover a visit to the ER if you are not admitted to the hospital
  • If you are admitted to the hospital, Medicare PartA will cover you, but only if you are admitted for more than 48 hours
  • Medigap insurance can help cover the instances when Medicare Parts A and B will not help with coverage in the ER

Occasionally, we experience things we could never predict, and we may end up needing emergency care. If you are 65 or older, you may be curious about how Medicare works when you have to go to the emergency room.

There are plenty of large and small emergency rooms that take Medicare. If you are having an emergency, even if it’s during a doctor’s regular office hours, you should go straight to the emergency room.

While a Medicare emergency room fee schedule is something you may have to consider after your trip to the ER or an urgent care, when you’re in the moment, the last thing you want to worry about is money.

So do emergency rooms and urgent care take Medicare? Does Medicare cover urgent care and emergency room visits?

Most emergency rooms and urgent care facilities do take Medicare insurance. Like most other health insurance options, Medicare is commonly used in emergency situations and is accepted in most places.

If you’re curious to see Medicare insurance quotes for small emergency rooms, keep in mind that different plans will vary when it comes to ER fees.

This is especially true for Medicare Advantage plans. Because Medicare Advantage insurance companies that cover small emergency rooms are technically independent insurance companies, their rates and coverages may be different from those of Original Medicare.

You can use our free tool above to compare Medicare insurance rates for small emergency rooms today and see how much you could be saving.

How does Medicare work in a small emergency room?

When you visit urgent care or the ER, you will initially be using Medicare Part B for your coverage.

If you are not admitted to a hospital, Medicare Part B will cover 80% of your visit to an emergency room once you have met your deductible. In 2021, the deductible for Medicare Part B is $203.

Once you are admitted to the emergency room for care, Medicare plans will typically cover you with your Plan A coverage.

The tricky part about ER visits with Medicare is the time frame. If you visit an emergency room but are not admitted, Medicare Part A does not go into effect.

But Medicare Part A doesn’t automatically cover you if you’re admitted to the hospital either. You have to be admitted to the hospital for two consecutive evenings — or over 48 hours — for Medicare Part A to kick in.

Once you are admitted for two nights or longer, Medicare Part A will cover your inpatient hospital stay and the fees associated with your outpatient ER care.

You may feel like your health insurance costs too much. If that’s the case, you can compare rates to see what other companies are charging for the same types of coverage.

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How much will I pay to visit the ER if I have Medicare?

Your fees for the ER will vary depending on the reason for your visit, how long you stay, and whether you’re admitted to the hospital.

If everything you do in the emergency room is outpatient — meaning you’re never admitted to the hospital — an Original Medicare plan will cover 80% of your fees once you’ve met your Plan B deductible.

Most Medicare Advantage plans will also cover around 80% of the fees associated with your visit.

Once you are admitted to the hospital, you will receive full coverage with your Medicare Part A plan as long as you stay in the hospital for two nights. If you are admitted but do not stay 48 hours or more, your coverage will vary.

Regardless of how much Medicare will cover, you should still plan to pay all of your coinsurance and copay fees for your visit to an emergency room.

You may want to consider searching for affordable Medicare insurance for small emergency rooms. There is a chance you could be saving on your rates by switching to a Medicare Advantage plan.

Before you buy Medicare insurance for small emergency rooms, be sure to use our free tool below to compare rates and coverage options and see how much you could save.