Does Patient First Accept Medicare? What You Need to Know Before Your Visit

Patient First accepts Medicare at most of its locations, but not all, and the terms vary by state and individual clinic

Patient First is an urgent care chain with hundreds of clinics across the eastern United States. Most Patient First locations do take Medicare, but you cannot assume yours does — acceptance depends on whether that specific clinic is enrolled in Medicare, which state it operates in, and whether you have Original Medicare or a Medicare Advantage plan. Before you go, you need to call the clinic directly or check your plan documents, because showing up without confirmation can leave you responsible for the full bill.

The short version: Patient First clinics are independently owned and operated under a franchise model, which means each location makes its own decisions about which insurance plans to accept. Some accept Medicare, some do not. Some accept Original Medicare but not certain Medicare Advantage plans. The only way to know for certain is to contact the specific clinic where you plan to be seen.

Key Takeaways

• Patient First locations are independently operated, so Medicare acceptance varies by clinic — you must call ahead to confirm.
• Most Patient First clinics accept Original Medicare, but some may require you to pay upfront and file a claim yourself.
• Medicare Advantage plans (like Humana, United, Aetna) may not be accepted at all Patient First locations, even if Original Medicare is.
• If a clinic does not accept your plan, you will be billed as an out-of-network patient and responsible for the full cost unless you pay out of pocket.
• Call the clinic at least one day before your visit to confirm they accept your specific Medicare plan and ask about copays or upfront costs.

How to confirm Patient First accepts your Medicare plan

Start by calling the Patient First location you plan to visit. Ask specifically whether they accept your type of Medicare coverage — Original Medicare, Medicare Advantage, or both. Have your Medicare card handy when you call so you can give them your plan name and member ID if they ask.

If you have a Medicare Advantage plan (such as Humana, United Healthcare, Aetna, or Cigna), ask whether that specific plan is in-network at that clinic. Medicare Advantage networks are narrower than Original Medicare, and a clinic may accept Original Medicare but not your particular Advantage plan. The clinic staff should be able to tell you in one call.

You can also check your Medicare Advantage plan's website or member handbook, which lists in-network urgent care providers by location. Search for Patient First clinics in your area and see whether the one nearest you appears on the list. If it does not appear, call the clinic directly before going — the list may not be fully current.

What to expect if Patient First accepts your Medicare

If the clinic accepts your Medicare plan, you will typically pay a copay at the time of your visit — usually between $25 and $50 for an urgent care visit, depending on your plan and the clinic. Bring your Medicare card and any secondary insurance card you have. The clinic will bill Medicare directly for the rest.

Some Patient First locations that accept Medicare may still ask you to pay the full bill upfront and then file the claim yourself. This is less common but does happen. If the clinic tells you this when you call, ask whether they can bill Medicare on your behalf instead. If they cannot or will not, you can choose to pay out of pocket and submit the receipt to Medicare yourself, or go to a different urgent care that will bill directly.

Original Medicare typically covers urgent care visits at in-network clinics with no prior authorization required. You do not need to call Medicare or your primary care doctor first. Walk in, be seen, pay your copay, and Medicare handles the rest.

What happens if Patient First does not accept your Medicare

If the clinic does not accept your Medicare plan, you have three choices: pay the full bill out of pocket, go to a different urgent care that does accept your plan, or ask whether the clinic will bill you as an out-of-network provider and let you submit the claim to Medicare yourself.

If you pay out of pocket, keep your receipt and itemized bill. You can then submit both to Medicare, and Medicare may reimburse you for part of the cost — but you will have to wait for the reimbursement, and you may not recover the full amount. Out-of-network urgent care visits are usually more expensive than in-network ones.

The better option is to find an in-network urgent care before you go. Use the urgent care locator on Medicare.gov, or call your Medicare Advantage plan's customer service line and ask which urgent care clinics near you are in-network. Most areas have multiple options.

Differences between Original Medicare and Medicare Advantage at Patient First

Original Medicare is accepted at more Patient First locations than Medicare Advantage plans are. If you have Original Medicare, your chances of being accepted are higher, but you still need to call ahead because some clinics have chosen not to accept Medicare at all.

Medicare Advantage plans have smaller networks. Your plan's customer service number (on the back of your card) can tell you which Patient First locations, if any, are in-network for you. Some Advantage plans may have zero Patient First locations in your area, which means you would need to go elsewhere or pay out of pocket.

If you are considering switching from Original Medicare to a Medicare Advantage plan, or vice versa, check which urgent care clinics near you accept each type. This matters if you use urgent care regularly or live in an area with limited options.

What documents to bring to Patient First

Bring your Medicare card, even if you have already called to confirm acceptance. Bring any secondary insurance card you have (such as Medicaid or a supplemental plan). Bring a photo ID and your insurance member ID numbers. If you have a Medicare Advantage plan, bring that card as well.

If you have been to Patient First before, they may have your information on file, but it is still good to bring your cards so the staff can verify current coverage. Insurance information changes, and the clinic needs to bill the correct plan.

Frequently Asked Questions

Can I just show up to Patient First without calling first?

You can, but you risk finding out at the desk that they do not accept your Medicare plan. If that happens, you will either have to pay the full bill out of pocket or leave and go elsewhere. Calling one day ahead takes five minutes and prevents this problem.

Does Patient First accept Medicare Advantage plans?

Some Patient First locations do, but not all, and it depends on which Advantage plan you have. Call the specific clinic and give them your plan name, or call your plan's customer service line and ask whether that Patient First location is in-network for you.

Will I have to pay anything upfront if Patient First accepts my Medicare?

You will likely owe a copay at the time of your visit, usually $25 to $50. Some clinics may ask you to pay the full bill upfront, though this is uncommon. Ask about copays and upfront costs when you call to confirm acceptance.

What if I go to Patient First and they say they do not accept Medicare after I arrive?

You can pay out of pocket and submit the bill to Medicare for possible reimbursement, or you can leave and go to an in-network urgent care instead. To avoid this, call ahead. If you do end up paying out of pocket, keep your itemized bill and receipt.

How do I find a Patient First location that accepts Medicare near me?

Use the urgent care finder on Medicare.gov, or call your Medicare plan's customer service line. You can also call Patient First locations directly in your area and ask whether they accept Medicare. Have your plan information ready when you call.