February 5 2018

Know Before You Go: The Difference Between the ER and Urgent Care.

Long ago, before there were smartphones (yep, such a time existed), there was only one place to go for medical care if your doctor’s office was closed – the hospital emergency room (ER). Fortunately, that’s no longer the case.

Now you have your pick of places for after-hours care including urgent care clinics, free standing emergency rooms and the good old-fashioned hospital emergency room. So, what’s the difference and why is it important?

First, you’ll want to consider two things.

  1. Is it an emergency?

Serious or life-threatening injuries or illnesses that require immediate attention or a specific level of care are emergencies. Sore throats or extreme paper cuts are not. If it’s enough to call 911, then head to an emergency room STAT. Your insurance will cover this visit if it’s a medical emergency, but you’ll need to pay your portion of the bill depending on which plan you have, and how much you’ve used your plan this year.

  1. If it’s not an emergency, is your doctor’s office closed?

Sometimes minor illnesses or injuries can be treated during the same day at your primary care physician’s office. But when it’s after hours, or you need care as soon as possible, or you don’t have a primary care doctor, head over to one of Friday’s in-network, urgent care clinics for treatment. This is typically a less expensive option for you than visiting the emergency room.

Simply speaking, if it’s not an emergency, don’t go to an emergency room. Otherwise you’re going to end up paying a lot of extra money for a level of care you didn’t/don’t need. Here’s a breakdown that may help:

Urgent Care Clinic: The lowest-cost option for after-hours care of minor illness and injury

Best for: Common sprains, shallow cuts, rashes, sore throat, colds, urinary tract infection

Cost: $75 fee* (called a “co-pay”), your deductible is waived (you just pay the $75 even if you haven’t hit your deductible).

*This is the fee for all Friday health plans except Value Choice 100 and Bronze HSA. Value Choice 100 and Bronze HSA require you pay for the urgent care visit until you hit your deductible. After that, the visits are $0.

How to find one: Use the Friday provider search to find an in-network urgent care center near you

Hospital Emergency Room: For life- or limb-threatening situations

Best for: Serious or life-threatening conditions such as a heart attack, stroke or a car accident. Here’s a few of the symptoms that are best evaluated in an emergency room.

  • Persistent chest pain, especially if it radiates to your arm or jaw or is accompanied by sweating, vomiting or shortness of breath
  • Difficulty breathing
  • Any severe pain, particularly in the abdomen or starting halfway down the back
  • Sudden clumsiness, loss of balance or fainting
  • Sudden difficulty speaking, or trouble understanding speech
  • Sudden weakness or paralysis, especially on one side of the face or body
  • Severe heart palpitations
  • Sudden, severe headache
  • Broken bones or dislocated joints
  • Deep cuts that require stitches — especially on the face — or a large open wound that won’t stop bleeding
  • Head or eye injuries
  • Severe flu or cold symptoms
  • High fevers or fevers with rash
  • Severe and persistent vomiting or diarrhea
  • Serious burns

Cost: You must first reach your deductible, then insurance pays a percentage of costs until you reach your maximum out-of-pocket costs for the year. ER visits could cost thousands of dollars, depending on your treatment.

How to find one: Visit your nearest emergency room for a true medical emergency.

Free Standing Emergency Room: For life- and limb-threatening situations

Best for: Same as hospital emergency rooms, these are best for serious or life-threatening conditions. Do not visit one if you have a condition that can be treated at an urgent care center.

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