Moab and southeast Utah · Emergency costs for 2027

What Is the ER Copay in Moab on Medicare Advantage in 2027?

$130 on nine of the 12 general Advantage plans in Grand County, and $115 on the other three. Every one waives it if you're admitted within 24 hours. Here's the whole bill for a bad night, from the ambulance to the bed upstairs.

Medicare On Main Data Desk

Published November 5, 2026 · 6 min read · Reviewed by Brian Penner, 22+ years in Medicare

The ER line, plan by plan

Every Advantage plan files its emergency cost sharing in CMS's 2027 plan benefit file. For the 12 general plans sold in Grand County, the ER entry is a single flat copay per visit. None adds a deductible or a coinsurance percentage. Since the emergency room is the one door everybody in Moab knows, I put the other lines of an emergency next to it.

Sources: CMS 2027 benefit file, sections 4 (emergency and urgent care), 10 (ambulance) and 1a (inpatient hospital), in-network amounts; premiums and caps from the CMS CY2027 landscape. You still pay your Part B premium. Listing a plan is reporting, not a recommendation, and we do not offer every plan available in your area.

The $15 gap between $115 and $130 is real but small. The bigger differences sit in the columns beside it. The ambulance ride ranges from $230 to $350, and a hospital admission ranges from $1,580 to $2,750 for the copay days, before the yearly cap steps in.

When the ER copay disappears

All 12 plans filed the same waiver: if the ER doctor admits you to the hospital within 24 hours, you don't pay the $115 or $130. You pay the plan's inpatient copay instead, which on these plans runs $395 to $685 a day for the first four to six days.

Two cautions. First, "admitted" means a formal inpatient order. If you're kept overnight under observation, you're still an outpatient, the ER copay stands, and observation is billed under the plan's outpatient hospital line. Ask the nurse which status you're in. Second, if you're transferred to Grand Junction, the ambulance or flight is its own charge on top of the ER and hospital lines.

Moab Regional, Grand Junction or a trailhead: the plan still pays

People sometimes worry their HMO won't pay if the ambulance goes to the "wrong" hospital. For emergencies, that isn't how it works. 42 CFR § 422.113 makes an Advantage plan financially responsible for emergency and urgently needed care "regardless of whether the services are obtained within or outside" its network, and "regardless of whether there is prior authorization." That holds at Moab Regional's emergency department, at St. Mary's in Grand Junction, and anywhere else in the country.

Where the network does matter is after you're stable. Follow-up care, a planned admission or a specialist visit on an HMO generally needs to be in network, so it's worth knowing your plan's 2027 network before something happens. Our Moab 2027 plan changes post covers what's different on the Grand County shelf.

How this compares with Original Medicare at a critical access hospital

On Original Medicare there's no single ER copay. Medicare.gov says you pay "a copayment for each emergency department visit and a copayment for each hospital service you get," plus 20% of the approved amount for the doctor after the Part B deductible. Moab Regional is a critical access hospital, and there your hospital share is figured on the hospital's charges rather than a Medicare rate. I walk through that math in why a Moab hospital bill costs more on Medicare.

The short version: with Original Medicare alone, an ER visit with imaging in Moab can cost more than any Advantage copay in the table. With a Medigap plan that pays Part B coinsurance, such as Plan G, it's covered after the Part B deductible. Plan N works the same way, except you may owe up to $50 for an ER visit that doesn't end in an admission.

Urgent care in Moab is the cheaper door

For something that isn't an emergency, such as a sprained ankle, a cut that needs stitches or a fever, Moab Regional's urgent care is walk-in only, open 10 a.m. to 8 p.m. weekdays and 10 a.m. to 6 p.m. on weekends (holiday hours vary; 435-719-5599). The Humana plans file $40 or $50 for urgent care. UnitedHealthcare's six file a range of $0 to $50, which means the copay depends on the kind of location, so read the urgent care line of the plan's Summary of Benefits. Because this urgent care is run by the hospital, ask your plan which copay applies there before you need it.

Chest pain, trouble breathing, signs of a stroke or a serious fall belong in the ER or a 911 call, whatever the copay.

Monticello and Blanding

San Juan County has 11 general plans for 2027, the same Humana six plus five UnitedHealthcare plans. Eight charge $130 for the ER and three charge $115, with the same 24-hour admission waiver. San Juan Hospital in Monticello and Blue Mountain Hospital in Blanding are critical access hospitals too, so the Original Medicare comparison above applies there as well.

How we know all this: the Medicare On Main Data Desk frames every article with public data. Here that means CMS's 2027 plan benefit and landscape files, the federal Medicare Advantage emergency rule, Medicare.gov's emergency department page and Moab Regional Hospital's own urgent care and emergency pages, all read November 5, 2026. Benefits can differ in a plan's final documents, so confirm them in its Summary of Benefits and Evidence of Coverage. Carrier names are factual reporting, not endorsement. This is education, not advice. Compare plans with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.