There are times when your health needs emergent care and other times when it is less urgent. First, you need to decide how serious it is and how quickly you need medical care. Today, there are several choices of where you receive your care. The differences vary in cost, time and required  medical treatment you need; these include, Hospital-based emergency departments, freestanding emergency rooms, and urgent care clinics. 

Hospital-based emergency departments and freestanding emergency rooms treat life- threatening conditions.  In addition, the staff consists of emergency physicians and nurses and lab technicians.  

Urgent Care Clinics are either freestanding or in retail clinics (CVS, Walmart).  Depending on your needs, both are a good option for treating minor or rising medical conditions. Unfortunately, individuals often confuse freestanding emergency rooms with urgent care clinics. You should always know which facility your insurance covers and when you should visit them to fit your needs. 

So, how do you know what is the best fit for your needs?  

Needs: Is it urgent?  How quickly do you need care?   Emergency room or urgent care clinics vary depending on your needs. The answer lies in the Prudent Layperson Standard: “Any medical or behavioral condition that would lead a prudent layperson, possessing an average knowledge of medicine and health to believe that the severity of the condition would result in death or harm to a physical organ.” This is the standard for an emergency department/room visit.  Urgent care clinics are an excellent option when you can’t go to your regular physician or during after-hours. Most urgent care clinics are covered by insurance and staff nurse practitioners, physician assistants, and family medicine doctors. Urgent care centers treat various medical conditions, including blood testing, casting broken bones, and vaccinations.  

Costs:   The average emergency room visit costs 40 percent more than a month’s rent. Prices vary depending on your coverage. An emergency room visit can cost over $1,000 per visit, depending on tests and specialists used. An urgent care visit averages $100 per visit. There are times when a visit to the emergency room or department is crucial, and you can’t avoid these costs. 

Time:   You may ask why does it take so long when you enter an emergency department? Typically, it is due to overcrowding and using the emergency department for non-urgent care. Nearly one-third to one-half of all emergency room visits are due to non-urgent care. In addition, Emergency rooms/departments have a five-tier triage to assure the sickest person gets treatment first. So, if your condition is non-life-threatening, your time is more valuable at an urgent care clinic. 

Don’t forget about telemedicine.—this is a cost and time-saving option. Insurance coverage is protected by federal, state, and insurance company laws and vary by state. Check with your insurance company to verify your coverage.

Let Medical Advocacy Plus MAP you in the right direction! Contact me here for your reference cheat sheet!

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