Pays 100%, after $250 Copay. Urgent Care Coverage is available for all of the employee's eligible children age 6 months to age. NORTH CAROLINA – Medicaid. Benefits Enrollment Guide April 1, 2015 – March 31, 2016. Apr 1, 2015 Lower Copay for Urgent Care(Current Plan – $75/New Plan $60) increase in salary. Righttime Medical Care offers urgent care by appointment or walk-in to adults and children, 365 days a year. Righttime has 19 Care Centers throughout Maryland - Annapolis, Arundel Mills (Hanover), Bethesda, Catonsville, Columbia, Frederick, Gaithersburg, Germantown, La Plata, Olney, Pasadena, Pikesville, Potomac, Rockville, Silver Spring, St. Mary's (California), Towson, Waldorf and Waugh. A Medicaid plan with a $0 monthly plan premium and low or no copays for doctor visits, lab tests, prescription drugs, hospitalization, urgent care, emergency care, maternity, dental, vision, hearing, wellness, and more. Sponsored by New York State, this plan is for qualified low-income families and individuals under 65. Emergency care/urgent care. $0 copay for emergency room, $0 copay for urgent care center. Medicare Part D prescription drug coverage. $0/$1.25/$3.40 copays for Tier 1 generics, $0/$3.80/$8.50 copays for Tier 1 brand until $5,100 yearly out-of-pocket limit is met, then copays are $0. AHCCCS Copayments (Copays): Copays are amounts members pay directly to a provider for each item or service they receive at the time of a service. Copays can be mandatory (also known as required) or optional (also known as nominal) as explained below.

Covered Services

BadgerCare Plus covers the services listed below. These services could change, so you should always check with your provider or call ForwardHealth Member Services at 800-362-3002 for the most up-to-date information about whether a service you need is covered and if there are any limits on the services you need.

• Case management services
• Chiropractic services
• Dental services
• Family planning services and supplies
• HealthCheck: Preventive health care for children and young adults through age 20 (Early and Periodic Screening, Diagnosis and Treatment benefit)
• Some home and community-based services
• Home health services or nursing services if a home health agency is unavailable
• Hospice care
• Inpatient hospital services other than services in an institution for mental disease
• Inpatient hospital, skilled nursing facility, and intermediate care facility services for patients in institutions for mental disease who are:
  • Under 21 years of age
  • Under 22 years of age and were getting services when they turned 21 years of age
  • 65 years of age or older
• Intermediate care facility services, other than services at an institution for mental disease
• Laboratory and X-ray services
• Medical supplies and equipment
• Mental health and medical day treatment
• Mental health and psychosocial rehabilitative services, including case management services, provided by staff of a certified community support program
• Nurse midwife services
• Nursing services, including services performed by a nurse practitioner
• Optometric/optical services, including eye glasses
• Outpatient hospital services
• Personal care services
• Physical and occupational therapy
• Physician services
• Podiatry services
• Prenatal care coordination for women with high-risk pregnancies
• Prescription drugs and over-the-counter drugs
• Respiratory care services for ventilator-dependent individuals
• Rural health clinic services
• Skilled nursing home services other than in an institution for mental disease
• Smoking cessation treatment
• Speech, hearing, and language disorder services
• Substance abuse (alcohol and other drug abuse) services
• Tuberculosis (TB) services

Copays

A copay is a set amount of money you pay for a medical service. You pay this amount each time you get a service.

Who has to pay copays?

Many BadgerCare Plus members have to pay copays. You may have to pay copays if your monthly income is more than the amount listed in the table below for your family size. You still may not need to pay copays though. See the Who doesn't have to pay copays? section for more information.

Family Size	Monthly Income
1	$531
2	$718
3	$905
4	$1,091
5	$1,278
6	$1,465

Who doesn't have to pay copays?

The following BadgerCare Plus members do not have to pay copays:

• Children under age 19
• Children in foster care
• Children in adoption assistance
• Youth who were in foster care on their 18th birthday who enroll in BadgerCare Plus until age 26
• Pregnant women during the pregnancy and for at least 60 days after the end of the pregnancy
• American Indians or Alaska Natives of any age or income level, who get or have gotten health items or services from an Indian health care provider or by referral under contract health services
• People getting hospice care who are terminally ill
• Nursing home residents
• Members who enroll by Express Enrollment

How much are copays?

Most copays are between $0.50 and $3.00, depending on the service. If you get more than one service, you may have more than one copay.

Cost of Service	Copayment
Up to $10.00	$0.50
From $10.01 to $25.00	$1.00
From $25.01 to $50.00	$2.00
Over $50.00	$3.00

BadgerCare Plus members who are age 19-64, are not pregnant, and do not have children under age 19 living with them, have an $8 copay if they choose to get medical care in the emergency room when it is not an emergency. There is no copay for getting care when it is an emergency.

Is there a limit to the amount I pay each month?

Yes. Your copay amount will never be more than 5% of your total income before taxes or other deductions. Your monthly copay limit is based on your income, your family size, and who in your household has copays. If you also pay premiums for your BadgerCare Plus coverage, we will subtract your monthly premium from your copay limit.

If you owe copays, you will get a letter titled 'About Your Benefits,' letting you know how much your monthly copay limit is.

If your copays reach your limit before the end of a month, we will send you a letter letting you know. You will not have to pay copays for the rest of the month.

Payment & Insurance

WellStreet Urgent Care accepts most private insurances, Medicaid, Medicare, and Medicare Advantage. No insurance? No problem! We offer competitive self-pay rates for those patients without insurance.

All payments, including your co-pay, coinsurance and/or deductible, are due at the time of service. WellStreet accepts cash, debit and all major credit cards.

Billing Information

For all billing related questions, please contact us via phone or email and a member of our friendly staff will personally assist you.
Email: billing@wellstreet.com
Phone: (888) 341-3360

Credit Card On File

Healthcare is constantly evolving, driving change to healthcare insurance and affecting healthcare providers and patients. As a result, you are likely experiencing an insurance plan that has higher co-payments, co-insurance, and/or deductibles, which leads to greater payment responsibility for the patient.

We require most patients, excluding self-pay, to leave an encrypted and secure credit card number on file, making payment easier for the patient and our practice. We do not store your information at our urgent care facilities but through a secure solution called InstaMed, giving us the ability to send you electronic statements and provide you with the option to pay your bill conveniently online.

Please be assured that your card will only be used to pay balances after your insurance company has processed your claim.

Insurance Providers

Below is the current list of the insurance plans in which we are participating. If you have any questions, please email our Billing Office at billing@wellstreet.com. If we are not on your insurance plan, we can still treat you and offer a cost effective self-pay rate OR provide you the necessary paperwork to send into your insurance provider, though we cannot guarantee coverage.

Medicaid Urgent Care Copay Plan

Urgent Care Self Pay

No insurance? No problem! We offer competitive self-pay rates for those patients without insurance.

Urgent Care – Basic$155

Includes:

• In-house labs
• Visits for Birth Control Only
• Visits for outside packing or suture removal

Urgent Care – Intermediate$195

Includes above tier in addition to:

• X-Ray (one body part)
• Administration of Medications IM medications and/or Flu Vaccines
• Ear Irrigation

Urgent Care – Advanced$250

Includes above tiers in addition to:

• X-Ray (multiple body parts)
• Burn Care
• Laceration repair
• Eye Numb/Eye Wash
• Asthma Treatment (nebulizer)
• Administration of other vaccines (Tetanus/TDAP)
• Incision and Drainage

• Wound Care
• Intravenous Therapy
• EKG
• Foreign body/splinter removal
• Tetanus/TDAP Vaccination
• Note: External labs incur additional costs at time of services

COVID TestingStarting at $155

Includes evaluation, test, resulting and visit

Durable Medical Equipment

Physicals

Simple Physicals$25
Includes Sports Physicals, Camp Physicals
Intermediate Physicals$79
Includes Pre-professional Schools, Non CDL Licenses, Adoption Physicals, Insurance Physicals, College Physicals, Pre-employment Physicals*

Biometric Visits

Biometric Basic (Vitals & Body Comp)$37
Biometric Moderate (Basic + Total Cholesterol)$74
Biometric Advanced (Moderate + A1c Diabetes)$110

Nurse Only Labs

Performed In-House, Results Immediately

Cholesterol (Total, Fingerstick)$26
Drug Screen (6 Panel, In-house, Urine)$42
HbA1C (Hemoglobin A1c, Screen for Diabetes, Fingerstick)$37

Urgent Care Medicaid Near Me

Nurse Only Labs

Collected Here, Sent to Outside Lab, Results in a few days.

Lipid Panel (HDL/LDL/Triglyceride, Blood)$52
Drug Screen (Confirmation, Urine)$26
Alcohol/Ethanol (Blood)$42
Nicotine/Cotinine (Urine)$42

Vaccinations

Flu Vaccine$29
Td (Tetanus/Diphtheria, if injury- will need urgent care visit)$52
TdaP (Tetanus/Diphtheria/Pertussis-whooping cough, if injury- will need urgent care visit)$79
TB Test (PPD/Tuberculosis Screening)$37