Yes, in almost all cases. Urgent care is a covered benefit under most major medical plans, and it is typically billed at a lower copay than an emergency room visit for the same problem. The details that vary are the copay amount, your deductible, and whether the clinic is in your plan’s network.
Which plans Maxem Health accepts
Maxem Health accepts most major insurance plans, including:
- Blue Cross Blue Shield, Aetna, Cigna, Humana, United Health Care, Community Plan (UHC)
- Medicare, Medicare Rail Road, Aetna Medicare Supplement
- Mississippi Medicaid, Louisiana Medicaid, LA Bayou Plans including LHC, Amerihealth and Amerigroup
- Magnolia Health Plan, Molina, Ambetter from Magnolia Health, All Well, Wellcare, Healthy Blue, Aetna Better Health
- Tricare, TriWest, Department of Labor
- First Choice of Mississippi, First Health, Multiplan, Mississippi Physicians Care Network, America’s Choice Providers Network, Three Rivers Provider Network, People’s Health
If your plan is not on the list, call (228) 223-1927 to check. Maxem will also look at joining a network it is not currently part of.
How the billing actually works
Three numbers decide what you pay, and they are not the same thing.
Your copay is a flat amount for the visit type. Most plans set a lower copay for urgent care than for an emergency room, which is the whole financial argument for choosing urgent care when the problem is not an emergency.
Your deductible is what you pay before the plan starts contributing. On a high-deductible plan early in the year, “covered” can still mean you pay the full negotiated rate.
Network status determines the rate. In-network means the clinic has agreed pricing with your insurer.
Separately billed items are the usual source of surprise. Lab work sent to an outside laboratory is billed by that laboratory, not the clinic, and arrives as its own bill weeks later.
If your deductible is high or you have no insurance
The Maxem Health Discount Program is built for exactly this situation. It is a membership, not insurance, intended for people with no coverage or with major-medical-only plans that cover inpatient care.
An individual pays a $175 initial fee covering setup and the first visit, then $60 per visit. A family of two pays $250 then $75 per person per visit; a family of four pays $450 then $100 per person per visit. Almost all in-clinic services are included, X-rays among them.
It cannot be used if you want the visit billed to your insurance, and it cannot be used with any U.S. government plan. Prescriptions, immunisations, DME, workers’ compensation, outside lab work, rapid COVID antigen testing, DOT physicals and drug screens are all excluded.
What to bring and what to ask
- Your insurance card and a photo ID
- A list of your current medications
- Ask at check-in whether the clinic is in network for your specific plan, not just your insurer
- Ask whether any ordered lab work will be sent out, and who bills for it
When to skip urgent care and go to the ER
Urgent care is for problems that are not life threatening. Go to the emergency room or call 9-1-1 if you have any of the following:
- Severe chest pain
- Severe shortness of breath or difficulty breathing
- Suspected poisoning
- Severe abdominal pain
- Uncontrolled bleeding
- Confusion or change in mental status
- Sudden fainting, dizziness, numbness or weakness
- Coughing or vomiting up blood
- Injury to head or neck
- Extreme high fever
If you are experiencing any of these, call 9-1-1 immediately. Do not drive yourself.
Frequently asked questions
Is the urgent care copay lower than the ER copay?
Under most plans, yes, often substantially. Insurers price urgent care lower to steer non-emergency visits away from emergency departments.
Does Medicare cover urgent care?
Medicare Part B generally covers medically necessary urgent care visits. Maxem Health accepts Medicare, Medicare Rail Road and Aetna Medicare Supplement. Your share depends on your specific coverage.
Does Maxem take Medicaid?
Yes. Maxem accepts Mississippi Medicaid, Louisiana Medicaid and LA Bayou Plans including LHC, Amerihealth and Amerigroup, along with Magnolia Health Plan and Molina.
Can I use the Discount Program and my insurance together?
No. Maxem states the Discount Program cannot be used if you wish to bill insurance for the care you receive, and it cannot be used with any U.S. government plan.
Walk in at a Maxem Health clinic
Maxem Health Urgent Care has 15 clinics across Mississippi, Louisiana and Oregon, open seven days a week including holidays. Most clinics run Monday to Saturday 8am to 8pm and Sunday 9am to 6pm, though hours vary by location. No appointment needed. Walk in, or save your spot online before you leave the house.
Save your spot at your nearest Maxem Health clinic, or find clinic addresses and hours.
This article is general health information, not medical advice. It does not replace an evaluation by a licensed provider. If you are worried about your symptoms, get seen.