Does Medicare Cover MinuteClinic Visits?

MinuteClinic is a walk-in clinic that it says is much less expensive than a visit to urgent care. MinuteClinic is a CVS Health company that offers retail clinic services.

Dr. Douglas Smith and his patient Rick Krieger, along with Stephen Pontius, founded MinuteClinic in Minneapolis, Minnesota, as QuickMedx. MinuteClinic operates in 33 states and the District of Columbia, with over 1,100 facilities.

If you are considering seeking treatment at one of their facilities, one question you may have is, “Does Medicare cover MinuteClinic visits?”

In this article, we answer the question in clear, plain English. You will also find the average costs of minute clinic appointments and other helpful info.

Does Medicare Cover MinuteClinic Visits?

The short answer is yes. Medicare will cover the cost of minute clinics. Though not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your minute clinic appointment. Below we look at what these are so you know what to expect.

Original Medicare Coverage of MinuteClinic Visits

Original Medicare (Medicare Part A and Part B) provides coverage for walk-in clinics such as MinuteClinic. This plan provides coverage for your walk-in clinics if considered medically necessary.

Does Part A or Part B Cover MinuteClinic?

Coverage for MinuteClinic and urgent care is provided by Medicare Part B because these facilities all work with patients on an outpatient basis. They do not offer inpatient care. Once approved, Medicare Part B covers 80 percent of the costs of minute clinics. You will pay for the remaining 20 percent. ‘

How to File a Reimbursement Claim

You may find that you’ll have to pay the bill for your MinuteClinic, or other urgent care, visit out-of-pocket and then file a reimbursement claim. If that’s the case, in order to file a reimbursement claim, you will need to submit the following:

A receipt of your urgent care visit
A letter explaining that the urgent care center does not accept Medicare
Claim form from Medicare

Medicare Advantage Coverage of MinuteClinic Visits

Medicare Advantage plans (Medicare Part C) also provide coverage for MinuteClinic. Advantage plans are required to cover everything Original Medicare covers. But they also cover a number of treatments, services, etc. that Original Medicare does not.

Exactly what an Advantage plan covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.

How Much Do MinuteClinic Visits Cost?

How much it costs for a visit will differ depending on the nature of your visit and how long you will be there. In some cases, you may find the cost of a visit to be either no, or very low, cost. However, it should not exceed $500.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always be sure to double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.