Original Medicare (Parts A & B): Urgently Needed Care
This is not emergency care. This is care provided at an urgent care center or by a provider other than you or your loved one's usual provider.
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How To Receive
Details on how to apply
Visit an urgent care center, walk-in clinic, or make an appointment with the nearest, first-available provider that accepts Medicare to address the urgent medical need.
The nearest, first available provider is in case you or your loved one's usual provider is not immediately available.
Arrange for the facility or provider to bill Medicare.
The facility or provider may request a copay upfront or bill the member later.
Follow through with any recommendations.
For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.
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Urgently needed services are provided to treat a nonemergency, unforeseen medical illness, injury, or condition that requires immediate medical care but, given the circumstances, may not be possible, or is unreasonable, to obtain services from in-network providers.
Examples of urgently needed services that the plan must cover out of network are:
Immediate care is needed on the weekend
The member is temporarily outside the service area of the plan
Services must be immediately needed and medically necessary. If it is unreasonable given the circumstances to immediately obtain medical care from an in-network provider then the plan will cover the urgently needed services from a provider out-of-network.
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