ER vs. Urgent Care vs. Telemedicine? When to Go Where
Your guide for deciding how to get the timely care you need, even during the pandemic.
You’re out for a bike ride, you lose your balance, tumble off and fall on your hand. You hear a CRACK. You don’t even want to look, but you already realize: You’ve probably broken a finger.
Your first impulse may be to rush to the emergency room (ER). But you pause to consider that during the pandemic, ERs could be filled with patients with COVID-19. It’s a good thing you’ve stopped to think because you might just save yourself some time and a lot of money if you go to an urgent care center (UCC) instead.
Seeking emergency care has become even more complex these days, as many people look to balance getting the care they need against the risk of contracting the coronavirus or overcrowding hospitals. But it’s always important not to delay necessary care.
So as the number of COVID-19 cases surges again, where should you go for medical help: UCC, ER, or for more minor conditions, a telemedicine visit? Here’s a shortcut: as your medical needs rise, you should first think telemedicine, then UCC, and finally, ER.
Check out our guide to help you make the right decision.
Why Use Telemedicine?
A virtual visit with a doctor can handle many conditions for which people often go to an UCC or even the ER such as colds and flus, bladder infections, or minor wounds or burns. None of these injuries or illnesses usually requires an in-person physical examination.
Plus, it remains a good idea to stay away from a health care facility if you can. Doctors and hospitals are expecting more patients with COVID-19 and must reserve their protective equipment and capacity for treating them.
Convenience: Eligible members can use Horizon CareOnline℠ to talk with a U.S. board-certified, licensed doctor via video, chat or phone, 24 hours a day, seven days a week with no appointment needed. It’s a good solution when it’s after hours or you’re traveling or at work.
Cost: A telemedicine visit can often cost less than an in-person visit, especially to an ER. During the pandemic, these virtual appointments are even more affordable. While this public health crisis continues, Horizon BCBSNJ is waiving out-of-pocket costs for members enrolled in a fully insured plan for covered services provided by an in-network health care professional for a telemedicine visit.
Why Use Urgent Care Centers?
UCCs have one purpose: to treat patients who have an injury or illness that requires immediate care but doesn’t rise to the level of an ER visit. For example, in 2017, headaches, urinary tract infections and respiratory infections ranked in the top 10 list of diagnoses treated at ERs. These all are candidates for urgent care center treatment.
UCCs are helpful when you need to interact physically with a doctor, such as receiving stitches for a cut – something that telemedicine can’t provide.
Convenience: Typically, UCCs are as close to your home as a local hospital ER (or closer) and are staffed by medical professionals who can treat and discharge you in an hour or less – compared to an average ER stay of four hours.
Cost: Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) members who get their insurance through their employers can have a co-pay as little as $5, and no more than $50, when they use a UCC in Horizon BCBSNJ’s network. Out-of-pocket costs for members are also cheaper than going to an ER.
Why Use the ER?
If you have a life-threatening condition, go to the ER. During the pandemic, hospitals are taking extra precautions to help keep patients safe.
Convenience: ERs are open 24/7, unlike UCCs, which do not offer around-the-clock care. Most local hospitals have an ER.
Cost: Visiting an ER can be a lot more expensive than going to a UCC. According to the nonprofit Health Care Cost Institute, the average ER visit cost was $1,389 in 2017, up 176% over the last decade. Depending on your specific plan, you could be responsible for up to hundreds of dollars in out-of-pocket costs for an ER visit.
ER vs. UCC vs. Telemedicine
Deciding where to go for care can also depend on when your accident or illness occurs (UCCs are open seven days a week but not 24 hours/around the clock like ERs) and the type and severity of your condition. Below is a quick guide on when to use an ER vs UCC vs. telemedicine:
Finding a UCC Near You
There is a quick and easy way to find a Horizon BCBSNJ UCC in your neighborhood. Today, Horizon BCBSNJ’s UCC network includes more than 153 urgent care centers across the state; a complete list can be found on Horizon Doctor & Hospital Finder.
You can make a telemedicine appointment using Horizon CareOnline. Check with your own doctor to see if they also offer virtual appointments.
Remember Your Primary Care Physician
The convenience of UCCs and telemedicine is helpful for busy members, but they should not replace a primary care physician or specialist, who offer continuity of care and a holistic look at your health. According to Dr. Steven Peskin, Horizon BCBSNJ’s Executive Medical Director for Population Health, “Many primary care doctor’s offices now offer same-day appointments, and evening and weekend hours. So instead of rushing to the ER or urgent care center, a call to your regular doctor may be the best first option.”
If, however, your regular doctor isn’t available when you have an urgent health need, we’ve got you covered. Horizon BCBSNJ requires UCCs to notify your primary care doctor of your visit so that she or he can keep your health records accurate and up to date, and keep your care coordinated.
There’s nothing pleasant about suffering a broken bone. But, paying less out-of-pocket, while waiting less time to get treated, can take a lot of the sting out of your health care experience.
*Based on ER and UCC visits in 2017 across all business (excluding Medicaid). Based on in-network and out-of-network claims. Includes self-funded account costs.