Blanding, Monticello and San Juan County · Doctor visits on Medicare

Does the Part B Deductible Apply at Southeast Utah Clinics?

It depends on what kind of clinic it is, and in Blanding you can have both kinds a few blocks apart. At a community health center, Medicare waives the $283 Part B deductible. At a rural health clinic, you pay it first. Same town, same Medicare card, two different bills.

Medicare On Main Data Desk

Published October 29, 2026 · 6 min read · Reviewed by Brian Penner, 22+ years in Medicare

Two clinic types, two sets of Medicare rules

Most doctor visits on Original Medicare work the same way: you pay the yearly Part B deductible, then 20% of the Medicare-approved amount. Congress set up two exceptions for rural and underserved places, and both show up in San Juan County.

A federally qualified health center, usually called a community health center, has to be a nonprofit or public agency serving an underserved area or population. In exchange for federal grants, it must offer free or reduced-cost care to people with low incomes (MedPAC). For Medicare patients, Medicare.gov puts it in one line: "The Part B deductible doesn't apply."

A rural health clinic sits in a rural shortage area and must have a nurse practitioner or physician assistant on staff. It doesn't have to offer reduced fees, and its Medicare rules are closer to the usual ones. Medicare.gov: "After you meet the Part B deductible, you generally pay 20% of the charges." CMS restated both rules in its claims manual on September 29, 2026 (Transmittal 13975).

Sources: Medicare.gov FQHC, Medicare.gov RHC, CMS manual ch. 9 § 40.1, MedPAC, October 2026.

Which San Juan County clinics are which

We pulled CMS's October 2026 enrollment files for both clinic types and filtered them to Utah. Five sites in San Juan County are on them:

Source: CMS FQHC Enrollments and CMS RHC Enrollments, files dated October 1, 2026, read October 29, 2026. Listing is not a recommendation; call the clinic to confirm what it bills for your visit.

Grand County doesn't appear in either file. Moab's primary care is billed under other rules, and if your care runs through Moab Regional Hospital's outpatient side, our post on why Moab hospital bills cost more on Medicare explains that math. The closest community health center to Moab on the CMS list is Green River Medical Center, about 50 miles away.

What the difference looks like on a bill

Take your first office visit of the year, on Original Medicare with no supplement.

• At a community health center, Medicare's 2026 base rate for a visit is $207.72, adjusted for local costs. You owe 20% of the lower of that rate or the clinic's charge, so about $40 for a routine visit as an established patient. No deductible comes first, and if your income is limited, the center must offer reduced fees.
• At a rural health clinic, you pay toward the $283 deductible first. If the deductible isn't met yet, a first visit can cost you the clinic's full charge up to that amount. After that you pay 20% of what the clinic charges. MedPAC notes that rural health clinics set their own charges and nothing caps them, so people "generally face higher cost sharing at RHCs compared with FQHCs."

Two catches apply at both. Most preventive care, like your annual wellness visit and many screenings, is $0 at either one. And lab tests or X-rays done during the visit are billed separately under the regular Part B rules, so an X-ray can still count toward your deductible even at a community health center.

How your supplement or Advantage plan changes it

Medigap Plan G pays the 20% Part B coinsurance but not the deductible. That makes the clinic type matter more, not less. At a community health center there's no deductible to pay, so a covered visit usually costs you $0. At a rural health clinic, the visit counts toward your $283 until it's met, then Plan G picks up the rest. (We compare Plan G and Plan N for Utah in this post.)

Medicare Advantage replaces all of this with your plan's own copay. For 2027, the plans sold in San Juan County come from UnitedHealthcare and Humana (see the 2027 San Juan County plans). Check that your clinic is in your plan's network before you enroll during Open Enrollment, which runs through December 7. The plan doesn't have to pay a community health center the full Medicare rate; MedPAC explains that Medicare makes up the difference to the center separately, so it doesn't land on you.

If you also use Indian Health Service care, the rules for how IHS and Medicare work together are on our Medicare and IHS page. And Medicare still pays community health centers and rural health clinics for video visits to your home through 2027, as we cover in Medicare telehealth in rural Utah.

Before your next appointment

1. Ask the front desk how the visit is billed. "Are you a federally qualified health center or a rural health clinic for Medicare?" is a normal question, and they'll know the answer.
2. If money is tight, ask about the sliding fee. Community health centers must offer one. It's based on income, and you can ask about it even though you have Medicare.
3. Look at your Medicare Summary Notice. It shows whether a visit went toward your deductible.
4. Plan for January. The deductible resets every year. CMS hasn't announced the 2027 amount yet; the Medicare Trustees estimate $292 (2027 Part B costs).

I've been helping people with Medicare for more than 22 years, and this one surprises people in Blanding and Monticello more than most. Nobody tells you that the sign on the clinic door changes your bill. Now you know which question to ask.

How we know all this: the Medicare On Main Data Desk frames every article with public data. Here that means Medicare.gov's Federally Qualified Health Center and Rural Health Clinic coverage pages, CMS Claims Processing Manual chapter 9 section 40.1 as revised September 29, 2026, MedPAC's October 2026 payment basics for both clinic types, and CMS's October 2026 FQHC and RHC enrollment files, all read October 29, 2026. Clinic and carrier names are factual reporting, not endorsement. We are not affiliated with Utah Navajo Health System, San Juan County Hospital or any clinic named here. 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.