Should I go to the emergency room or urgent care?

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An emergency care provider holds a clipboard as they explain care options to a patient.

Emergency room or urgent care? In-office visit or telemedicine? Where you seek care impacts your out-of-pocket health care expenses. Whether you’re dealing with chest pain, a sports injury, allergies or health screenings, find out where to go for care based on your medical needs.

When You Have an Urgent Need

Immediate care is needed in urgent or emergency situations.

  • Hospital-based emergency room: If you are facing a life-threatening situation, persistent chest pain or loss of consciousness, go to a hospital-based emergency room.
  • Urgent care facility: For non-life-threatening conditions such as sports injuries or cuts that require stitches, visit an urgent care facility.
  • Freestanding emergency rooms are another type of emergency care facility that can cost thousands more than urgent care facilities, so it’s essential to know where you’re being treated ahead of time. Freestanding emergency rooms include the word “emergency” in the facility name, are not attached to a hospital and offer more complex treatment options than urgent care.

When You Must Be Seen In-person

Sometimes, you must be seen in person for imaging, bloodwork and other medical tests that can’t be performed virtually, or for sensitive appointments that are better face-to-face. Use in-network providers and facilities, which will have negotiated rates within your health plan to help reduce costs.

When You Have Mild or Moderate Symptoms

Telemedicine is often a more affordable option when you need minor care for issues like congestion, sore throat or ear pain. You can also use these virtual appointments for a follow-up visit after a procedure or to request a medication refill. Visits are sometimes free (as part of some health plans) or are typically offered at lower costs than in-office visits.

It can also be a money-saving option when you’re sick after hours or when your regular health care provider’s office is closed. This can be more cost-effective than getting treatment in an urgent care facility or emergency room.

When You’re Well

Most major health plans offer preventive care at no additional cost. Take advantage of in-office screenings and checkups from in-network providers or facilities. Being proactive could help you avoid expensive treatment for more severe conditions that can result when issues aren’t detected early.

Keep preventive care visits focused on routine care only. Discussing an unrelated health issue could reclassify the visit as diagnostic, which could result in out-of-pocket costs. If you have a health concern, schedule a separate appointment.

When you receive an explanation of benefits (EOB) statement for preventive care, verify that the services are accurately submitted for no out-of-pocket costs.

Make Future Care Easier

It can be challenging to sort through care options during an emergency or when you’re not feeling well. You can take a few steps now to make future care a little easier:

  • Register for telemedicine. If your health plan provides telemedicine, set up your account before you need service. If you have a GuideStone® health plan, register for Teladoc®.
  • Identify in-network providers and facilities. Find out which urgent care clinics and hospital-based emergency rooms are in your plan’s network and familiarize yourself with the locations nearest you. If you have a GuideStone health plan that uses the Highmark® Blue Cross Blue Shield network, visit MyHighmark.com or call 1-866-472-0924 (the number on the back of your medical ID card).

Download our Where to Go for Care guide for more helpful information.

Proactive Choices for Better Outcomes

Taking a proactive approach to your health can impact your well-being and ability to advance the Kingdom. Whether you’re learning the differences between the emergency room and urgent care, choosing a health plan or making plans to get healthy, GuideStone is here to help. For more information, contact us at Insurance@GuideStone.org or 1-844-INS-GUIDE (1-844-467-4843), Monday through Friday, from 7 a.m. to 6 p.m. CT.

 


GuideStone welcomes the opportunity to share this general information. However, this article is not intended to be relied upon as medical advice, diagnosis or treatment.