Jul 07, 2017

Know where to go for care, before you need it

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Knowing where to go if you get sick or hurt can save you lots of time and money, and help you get the best medical care. How do you choose where to go when the unexpected happens?

The emergency room (ER) shouldn’t be your first stop — unless there’s a true emergency.

Go to the nearest emergency room or call 911 if:

  • There is a lot of pain or bleeding.
  • You think a bone is broken.
  • You are having trouble breathing.
  • You think the problem might get a lot worse if you don’t get help right away.
  • You think the problem could kill you.
  • There was no warning before your symptoms started.

If you need help but it isn’t an emergency, follow these steps: 

  • Call your doctor. He or she can help you decide whether you should go to an urgent care or come into the office.
  • Go to a retail health clinic. These are small offices in drug stores or other large stores. They are open on weekends, evenings and most holidays. If the clinic can’t help you, they’ll tell you where to go next and you won’t have to pay. 
  • Go to an urgent care center. Urgent care is for when you need to be treated right away, but your problem isn’t serious. These centers are open late at night and on weekends and holidays. 

When do I need urgent care?

While urgent and emergency situations are both serious, urgent care is for problems that need attention right away, but are not severe or life-threatening.

You should go to urgent care for things like an earache, sore throat, rash, sprained ankle, flu or a fever up to 104°. A higher fever might be an emergency.

Am I covered for emergency care?

Most health plans cover medical care at an emergency facility for situations like the ones listed above.

Am I covered for urgent care?

Urgent care is usually covered if it’s provided in a non-ER setting by a provider in the network. If you need urgent care and your doctor can’t see you right away, use your best judgment to decide what to do. Urgent care might not be covered at the same level as emergency care. But if you think you need to see someone right away, it’s best to get care now and find out what your benefits will pay later.

Your doctor can help you find the best place to get care. He or she can help you decide whether you should come into the office, go to the ER, or schedule an appointment to see a specialist.