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Health Insurance: Emergency Room Or Urgent Care?

Health Insurance: Emergency Room Or Urgent Care?

When it comes to emergency care, in the past there were two options: the primary physician or the emergency room

. If one's primary care doctor was unavailable, then it was common sense to go to the emergency room at the closest hospital. Recent years, however, have required individuals to modify their thinking and include the possibility for urgent care as a solution.

Health insurance companies have recognized the benefits of the reduced costs of urgent care and passed this down to clients. While actual co-pays vary across insurance companies, opting for an urgent care clinic in lieu of an emergency room can amount to significant savings.

However, the issue with this mindset is the potential for thrifty patients to choose urgent care in situations in which they should have gone straight to the emergency room. In these cases, individuals will either be instructed to go to the emergency room from the clinic or have an ambulance ride there. This doubling of services will result in a huge increase of out-of-pocket expenses.

There are many situations that warrant bypassing urgent care and heading directly for the closest emergency room. Individuals with neck or back pain following an auto accident should go this route as they could be suffering from fractures, and anyone with a concussion should be taken to the ER as well. Men and women with symptoms of a stroke or heart attack should also bypass the urgent care center as well, as the faster treatment is obtained, the less damage will result. Health Insurance: Emergency Room Or Urgent Care?


Anything that is not life threatening or suspected to cause severe, permanent damage, however, should be treated at an urgent care center. Wait times are often shorter (though not always), and the necessary diagnostic treatment is often readily available, including x-rays and sutures. Intravenous treatment is also offered at these locations for anyone with a mild or moderate case of dehydration, just one of the many treatments available at urgent care centers but generally not offered at physician offices.

Essentially, any mild to moderate illnesses or injuries can generally be treated at an urgent care facility, while life-threatening (emergency) cases should be addressed at an emergency room. Examples of common ailments that are appropriate to be treated at an urgent care center include stomach ailments, sore ankles, bruising, severe burning upon urination, and minor (but not severe) difficulty breathing.

With an emergency room visit costing $500 and up without including any tests or prescribed medications, it makes financial sense to go to an urgent care center when your physician is not available and an emergency room visit is not necessary. Visits usually range from $75 to $150 without insurance, with the quality of care that you would expect from any health care professional.

Always review your health insurance plan before an emergency or urgent medical situation occurs, and you can rest assured knowing all that is necessary regarding your coverage.

by: Casey Trillbar
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Health Insurance: Emergency Room Or Urgent Care?