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 your loved one's usual provider.

 Read
Cost
20% of the Medicare-approved amount for provider services; copay in a hospital outpatient setting; Part B deductible applies
Prior Authorization Required
No
Provider Referral or Order Required
No

How To Receive

Details on how to apply

  1. 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 your loved one's usual provider is not immediately available.

  2. Arrange for the facility or provider to bill Medicare.

  3. The facility or provider may request a copay upfront or bill your loved one later.

  4. 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.

Availability
Ongoing as needed

Everything you need is all in one place

Helpful app simplifies family caregiving by combining your loved one’s insurance benefits and medical records into one user-friendly platform while enhancing your caregiving skills

Get Helpful App
banner

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 network providers.

Examples of urgently needed services that the plan must cover out of network are:

Services must be immediately needed and medically necessary. If it is unreasonable given the circumstances to immediately obtain medical care from a network provider then the plan will cover the urgently needed services from a provider out-of-network.

Go to all guides

About us

Helpful is an app to make caregiving easier. We integrate your loved one’s insurance benefits, medical records and caregiving guides into an immediate, accessible and user-friendly experience. Helpful supports your care needs by eliminating administrative tasks and providing technology to support your caregiving experience.

Get Helpful App