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Urgently needed care

Urgently needed care

Care that a beneficiary receives outside of their Medicare health plan’s service area for a sudden illness or injury that needs medical care right away but isn’t life threatening. If it’s not safe to wait until a beneficiary arrives home to get care from a plan doctor, the health plan must pay for the care.

Care that a beneficiary receives outside of their Medicare health plan’s service area for a sudden illness or injury that needs medical care right away but isn’t life threatening. If it’s not safe to wait until a beneficiary arrives home to get care from a plan doctor, the health plan must pay for the care.

  • Urgently needed care refers to medical care that is needed right away because of an illness, injury, or other health condition that cannot wait until the individual’s next scheduled appointment. Urgently needed care may be needed outside of normal office hours or on holidays, and it may include services such as emergency department visits, urgent care visits, or home visits.
  • In the context of Medicare, urgently needed care is covered under Medicare Part B (Medical Insurance) if it is medically necessary and provided by a Medicare-approved provider. Medicare Part B covers a wide range of medical services, including emergency department visits, urgent care visits, and home visits.
  • To receive coverage for urgently needed care under Medicare Part B, an individual must be enrolled in Medicare Part B and must meet certain eligibility requirements. The individual must also see a Medicare-approved provider and must receive services that are medically necessary.
  • If a Medicare beneficiary needs urgently needed care, it is important they contact their healthcare provider or seek care at a Medicare-approved facility, such as an emergency department or urgent care center. If a beneficiary is unsure about where to go for urgently needed care, they can call a local Medicare office or the Medicare hotline for assistance.

Ensuring coverage for urgently needed care under Medicare Part B is crucial for beneficiaries facing unforeseen health emergencies. It guarantees timely access to essential medical services, promoting prompt treatment and potentially preventing serious health complications.

Discover more about Medicare coverage for urgently needed care. Download our comprehensive e-book today to learn how to access timely medical assistance when you need it most. Your health and well-being are our top priorities.

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