Where to go when you need care

When you or someone you love is sick or injured, where do you go for care? Your doctor’s office? The urgent care clinic? Or the emergency room? Sometimes, it’s hard to know what’s best. Here is a breakdown of your options.

1. The doctor’s office

Your doctor, or what we refer to as your primary care provider (PCP), should be your first call in most non-emergency situations. Your PCP knows you and your health history, including what medications you are taking and what chronic conditions might need to be considered in your treatment. Here are a few things to know about your doctor’s office:

• Most PCP’s are available by appointment only.
• Visits are typically in-person. Follow up visits may be virtual, depending on your provider and your condition.
• Costs vary but are usually lower than urgent care and are much lower than the cost of emergency care.
• Long wait times can typically be avoided by going to your doctor.

When to go to your doctor/PCP’s office:

• Routine checkups, preventive exams, tests and immunizations
• Concerns about chronic issues
• Injuries or illnesses that are not life-threatening, and can wait for a doctor’s office visit, including: 
  • Earaches
  • Sore throats
  • Fevers that respond to fever-reducing medications
  • Ankle sprains and other strains of muscles and joints
  • Coughs and colds
  • Abdominal pain or other symptoms that resemble an illness that is “going around”
  • Symptoms of anxiety or depression that have persisted for 2 weeks or more.

If your PCP/doctor isn’t available, you may be able see another practitioner who is part of the clinic or practice where you have established care. If you don’t have a personal doctor, search for one with the Find a Doctor/Hospital tool.

2. Virtual care

Virtual care, also known as telehealth, is a way to receive non-emergency care from a board-certified doctor from your phone, tablet or computer. Here are a few things to know about using virtual care:

• Virtual care visits may be covered the same as an in-person visit through your health insurance plan. Check your exact coverage in Blue Access.
• When necessary, you can get a prescription from a virtual care doctor.

When to use virtual care:

• When you don’t have transportation, or your work or family schedule makes it hard for you to get to the doctor’s office.
• When you don’t feel well enough to travel to a doctor’s office, but you need non-emergency medical attention.
• When your PCP isn’t available.
• When you’re away from home.
• Virtual care can be particularly helpful for illnesses, including:
  
  • Cold/flu
  • Fever
  • Rash
  • Sinus or ear infection
  • Pink eye

Virtual care isn’t meant to replace care from your PCP. It is meant to help fill in gaps in care when you are unable to see your doctor.

3. Urgent care

Urgent care clinics, also known as walk-in clinics, provide care without an appointment for injuries and illnesses. Urgent care is the best choice when you need care quickly, but it’s not an emergency, and your personal doctor is unavailable. Here are a few things to know about urgent care:

• Each urgent care clinic has its own operating hours, so be sure to check before you go.
• Typically, you will pay more for urgent care than a doctor’s office or a virtual care visit. Urgent care costs far less than emergency room care.
• Longer wait times are common in urgent care centers.
• Ensure the clinic is in-network in BlueAccess.

When to seek urgent care:

• If you can’t wait for a doctor’s appointment, if your doctor’s office isn’t open or your illness isn’t suitable for a virtual care visit.
• For injuries or illnesses that are not life-threatening, but can’t wait for a doctor’s office visit, including:
  
  • Sprains and strains
  • Minor broken bones
  • Minor cuts, scrapes and burns
  • Flu and fever (below 104°)
  • Earaches or sore throats

4. Emergency room

The emergency room is a hospital facility staffed 24 hours a day, 7 days a week, to provide care for life-threatening conditions requiring immediate care. In an emergency, it’s important to act quickly by calling 911 or going directly to the emergency room. Here are a few things to know about emergency rooms:

• It costs much more to receive care in an emergency room, compared to an urgent care center, virtual care or a doctor’s office. Download our brochure on healthcare vs. cost.
• You can face the longest wait times in emergency care rooms, if you go there for a situation that does not require immediate attention.

 When to go to the emergency room:

• Call 911 or go to the emergency room for life-threatening situations where you feel like a delay in care (even if it’s only a few hours) could negatively impact your health.
• For severe or life-threatening symptoms that require emergency care, including:
• Severe head injuries or broken bones
• Chest pain or shortness of breath
• Excessive bleeding or extreme pain
• Sudden blurred or lost vision          
• Mental health symptoms, including thoughts of harming yourself or others, severe confusion, delusion or mania.

 For a complete list of emergency situations, visit ACEP.org.

The emergency room can save your life if you’re seriously sick or injured. But for less severe health issues, you will get faster and less expensive treatment elsewhere. Instead, call your personal doctor, seek virtual care, or go to an urgent care center.

Mental Health Resources

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