Alabama’s Only 24/7 Eye ER Is Now Urgent Care. The New Sign Does Not Guarantee a Cheaper Medicare Bill

A 71-year-old in Tuscaloosa, Alabama wakes up seeing flashes, with a shadow creeping across one eye. For decades the next step was simple: drive to UAB Callahan Eye in Birmingham, home to Alabama’s only dedicated 24-hour eye emergency department, at any hour. That emergency department is gone. In its place is UAB Hospital-Callahan Eye Urgent Care. A Medicare patient could reasonably expect a smaller bill from the new sign alone, but the sign does not decide that.

What Changed on October 1

UAB permanently closed the emergency department at 8 p.m. on Sept. 30 and opened the urgent care at 8 a.m. on Oct. 1. It works as a walk-in clinic for urgent eye problems, and patients need no appointment.

Outside of operating hours, UAB sends patients to the nearest emergency department, where physicians can coordinate with Callahan if needed. The hours and care model changed. UAB’s announcement says nothing about how the new clinic bills Medicare. That is the detail patients need to know, because an urgent care visit inside a hospital outpatient department can cost more than the same care in a doctor’s office.

Medicare Pays by Billing Category

Medicare cost sharing depends on how the facility is classified and which services it bills. The same eye exam can produce two very different bills:

• Physician office or independent clinic: After the $283 Part B deductible for 2026, you generally pay 20% of the Medicare-approved amount for the clinician’s services, without a hospital outpatient copay.
• Hospital outpatient department: You generally pay 20% for the clinician’s services and also owe the hospital a copayment for the outpatient services it provides.

Medicare cautions that you may pay more for outpatient services you get in a hospital outpatient setting than you’d pay for the same care in a doctor’s office.

Say, as an example, Medicare approves $150 for the ophthalmologist’s exam and you have already met your deductible. Your share of that exam is $30. In a physician’s office, that may be all you owe for the exam itself. In a hospital outpatient department, a hospital copayment can come on top of it, and imaging or other tests can add more. Medicare caps the copayment for any single outpatient hospital service at the Part A inpatient deductible, which is $1,736 in 2026.

Compare that with the old emergency department. There, Medicare charged a copayment for each emergency department visit and a copayment for each hospital service, plus 20% of the doctor’s approved amount. If Callahan’s urgent care still bills as a hospital outpatient department, the bill can still have two pieces: the clinician’s charge and a hospital copayment. Changing the sign from emergency to urgent care does not, by itself, tell you whether that hospital charge disappears.

Who Pays the Difference

Original Medicare with Medigap Plan G: Once you meet the Part B deductible, Plan G generally picks up the Part B coinsurance and hospital outpatient copayments.

With only Original Medicare: You pay the 20% physician share plus any hospital outpatient copayments that apply. That makes the clinic’s billing status much more important.

Medicare Advantage: Your plan sets separate copays for urgent care, emergency care, and outpatient hospital services. The copay you owe depends on how the clinic codes the claim. A plan that lists a low urgent care copay may charge its outpatient hospital rate instead.

Every group now faces an after-hours gap. An eye injury at 4 p.m. on a Saturday sends you to a general emergency department first, with its own copayment and physician coinsurance. A follow-up visit at Callahan then brings a second set of bills.

Three Moves Before Your Next Eye Visit

1. Ask the billing question directly. Before you check in, ask whether the clinic bills Medicare as a hospital outpatient department and whether a facility fee applies. You can reach Callahan at 844.UAB.EYES. If the answer is yes, ask what a standard urgent visit costs under your coverage.
2. Confirm Medicare assignment. Ask whether the treating doctor accepts assignment. Clinicians who do accept the Medicare-approved amount as full payment. A non-participating doctor can bill you up to 15% more.
3. Check your plan’s copays this fall. Medicare Advantage members who rely on Callahan should compare urgent care, emergency, and outpatient hospital copays when shopping plans during open enrollment. People with Original Medicare and no supplement should price a Medigap policy, but first check whether their state lets them buy one without medical underwriting.

UAB changed the sign overnight. Your Medicare bill changes only if the way the clinic bills does too.

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