urgent care

Urgent Care or ER? How to Decide Where to Go

Kat Tretina — Fri, 02 Mar 2018 09:00:07 +0000

A few weeks ago, I was walking with my husband at the park when an enormous, bearlike dog came out of nowhere and barreled into me. Caught by surprise, I got knocked into the dirt. When the shock wore off, I realized my ankle had twisted in a way it wasn't meant to and I had trouble getting to my feet. Within an hour, my ankle had swollen to double its normal size and I couldn't put weight on it.

I was about to head to the emergency room (ER) — and the huge bill that would undoubtedly come with it — when I reviewed my insurance policy to see what my copay would be. In the paperwork, I found out that going to an urgent care facility would be much cheaper. I was thrilled and the urgent care facility I visited helped me get back on my feet (literally).

If you're sick or injured, your first instinct might be to head to the emergency room. However, doing so can come with a large bill. In fact, the average ER bill is a staggering $2,259, according to Cigna. Visiting a local urgent care center, where the average cost is just $176, might make more sense. Here are a few key things to consider before going to the hospital. (See also: How to Handle a Massive Medical Bill)

Seriousness of illness

When deciding where to go, consider just how serious your injury or illness ill. If you're sick or have an infection and your doctor is unavailable, you may think the ER is your best bet. However, some insurance companies don't cover ER visits for non-life-threatening emergencies. That means that if you have something like pink eye and go to the ER, you could end up footing the bill entirely on your own.

If you're not facing a true medical emergency, an urgent care facility is a cheaper and safer option.

Services

Although urgent care facilities are usually cheaper and more convenient than the ER, they have limitations. They tend to have X-ray equipment, EKGs, and lab testing, but lack the facilities needed for more complex illnesses or problems. And, urgent care centers usually just have one or two doctors available and no specialists. Because of these factors, urgent care facilities are best for short-term illnesses or injuries, such as:

Coughs.
Minor injuries or burns.
Fevers.
Stomach pain or vomiting.
Sore throat.

If you have a more severe injury or illness, an urgent care facility might not be able to give you the care you need. Instead, you may need the tests, expertise, and care that only a hospital can provide. You should head to an emergency room (or have someone take you) in the following situations:

Head injuries.
Allergic reactions.
Unconsciousness.
Deep wounds or severe burns.
Chest pain.
Major broken bones.

Availability

If you are hurt or sick outside of your doctor's normal business hours, both urgent care centers and the ER are useful options.

Although urgent care facilities tend to have longer hours than your normal doctor, they are not usually available around the clock. If you are injured late at night or very early in the morning, your only option may be the ER.

Wait times

Most urgent care centers operate on a first-come, first-serve basis. You could wait as little as five minutes to see a doctor or have X-rays done. You'll also get necessary treatments and be on your way home faster than you would seeking treatment at a hospital.

Emergency rooms work differently. They use a triage system, where patients are seen based on the seriousness of their condition. If you have a mild problem, such as a sprained ankle or a sore throat, you could wait several hours so that others can be seen first.

In-network vs. out-of-network

Many doctors working in emergency rooms are independent contractors. That's important to know, because that means they may not operate within your insurance provider's network. Visiting the ER and being cared for by an out-of-network physician can mean a huge bill later on.

If possible, going to an in-network urgent care center will be cheaper than going to the ER. However, if your illness or injury is serious and you need to go to the ER, you can request an in-network doctor when you fill out your admissions forms.

Payment plans

Depending on your condition and whether or not you have insurance coverage, you could be on the hook for a large medical bill regardless of what kind of center you visit. If you are short on cash, where you go can affect what payment options are available to you.

Most urgent care facilities require payment in full before you leave and don't offer payment plans. If you don't have insurance, you could have to pay hundreds or even thousands right away. Without that money in savings, you might have to rely on credit cards to pay it and end up in debt.

Emergency rooms often have more leeway. They may offer payment plans or even have charitable funds set aside to cover the costs of low-income patients. Talking to the billing department about your situation can help you identify all of your options so you can pay for necessary treatments. (See also: What to Do If You're Hit With a Huge Medical Bill)

Managing your medical bills

If you've already been hit with a big bill after medical treatment, don't panic. There are ways you can negotiate your medical bills and qualify for financial assistance or reduce how much you owe.

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This article is from Kat Tretina of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Cost Comparison: Emergency Rooms vs. Urgent Care Centers

Coupon Sherpa — Tue, 23 Feb 2010 15:01:28 +0000

Emergency rooms provide excellent care, but you can wait eons if you have a non-life-threatening problem and still pay through the nose. Understandably, ERs serve patients based on the severity of the problem and charge for access to their wide-ranging facilities.

The wait at urgent care centers, on the other hand, can be minimal, and the cost for services often runs one-fourth of what you'll pay at a hospital or one-half for a visit to your doctor.

Sometimes called a "doc in a box," these freestanding walk-in centers usually offer extended hours. Staffed by physicians, nurses, and fully-trained assistants, urgent care centers provide solid, basic care for non-life-threatening medical situations. Most can perform basic X-rays and lab work and dispense prescriptions.

Another difference between an ER and an urgent-care center is availability. ERs are required to provide 24-hour emergency care, whereas privately funded urgent care centers have the right to establish set hours.

If you experience symptoms of a heart attack or stroke, or feel your "life or limb" is in danger, go directly to an ER or call 911 and do not pass go. According to the American College of Emergency Physicians (ACEP), you should visit the ER if you have any of the following warning signs:

Chest pain or pressure
Uncontrolled bleeding
Sudden or severe pain
Coughing or vomiting blood
Difficulty breathing or shortness of breath
Sudden dizziness, weakness, or changes in vision
Severe or persistent vomiting or diarrhea
Changes in mental status, such as confusion
Heavy bleeding
Large open wounds
Sudden change in vision
Chest pain
Sudden weakness
Trouble breathing
Major burns
Spinal injuries
Severe head injury
Loss of consciousness
Abdominal pain

The ACEP recommends you visit an urgent care center for:

Sprains
Strains
Minor broken bones
Mild asthma attacks
Minor infections
Small cuts
Sore throats
Rashes
Minor burns
Urinary tract infections
Pelvic infections

We researched cost comparisons for the nine most common reasons people visit the ER. Estimates do not include medications or other follow-up services. The cost estimates were determined by calculating the average allowed amount on claims submitted for the Medica Choice Network. All costs represent a single visit.

1. Allergies

The average urgent care center charges $97 for allergy-related problems, whereas ERs standardly charge $345.

2. Bronchitis (Acute)

Urgent care average pricing is $127, while ER charges average $595.

3. Earache

This common childhood ailment will run $110 at an urgent care center and $400 at an ER.

4. Sore Throat

Visit an urgent care center for a sore throat, and your average bill will be $94; at an ER, the average tab comes to $525.

5. Pink Eye

Irritating, but not life threatening, Pink Eye runs $102 at urgent care and $370 at an ER.

6. Sinusitis

This inflammation of the sinuses can result in an infection, so it should be treated if the problem persists. Urgent care will charge $112 and ERs $617.

7. Strep Throat

"Streptococcal pharyngitis" usually appears suddenly with severe sore throat pain. It can be particularly frightening for children, is highly contagious, and requires immediate treatment, but an urgent care center will charge just $111 for a visit and an ER $531.

8. Upper Respiratory Infections

It's particularly important that those with asthma or emphysema deal with upper respiratory infections before they turn into pneumonia. Urgent care will charge $111, with the average ER bill coming to $486. If you're experiencing severe difficulties breathing, however, check with an urgent care center to ascertain if you should go directly to an ER for treatment.

9. Urinary Tract Infections

Experts recommend you see a doctor as soon as you experience urinary tract infection symptoms. Treatment at urgent care will run $110, as opposed to $665 for a visit to the ER.

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This article is from Coupon Sherpa of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread: