Where to Go When You Don’t Think it’s an Emergency

This blog is presented by Shara McClure, Senior Divisional Vice President, Texas Health Care Delivery for Blue Cross and Blue Shield of Texas.

Imagine walking into a freestanding emergency room because you have a cough. Imagine walking out with a prescription and a bill for more than $3,000. Although this seems like a nightmare, it has been a reality for thousands of Texans over the past several years.

In 2009, freestanding emergency rooms (ERs) began appearing in Texas. Freestanding ERs are not attached to hospitals and in most instances, are not a part of a hospital’s network of services or providers. Where are freestanding ERs located? You may notice them in affluent neighborhoods where there is already a large selection of health care options available.

How could freestanding emergency rooms (ERs) impact you?

• It is important to understand that freestanding ERs can charge up to 10 times more than urgent care centers charge for the same services.
• Many advertise that they accept all insurance plans. Be aware, accepting is not the same as being “in-network,” and often leaves consumers responsible for large portions of their bills.

The good news is that you have options. It's imperative to understand the choices you have available for non-emergency care like the cough mentioned above. You can often avoid an emergency room visit, and the ER bill. Essentially, this reduces your overall health care costs. If you think your health issue is life-threatening, don’t wait! Call 911 or go to the nearest ER. We’ve got you covered. However, when you don’t think it is serious or life-threatening, there are other paths available to you for those situations.

What are my options for non-emergency care?

• Path 1: Call Your Doctor
  If you have a family doctor or pediatrician, call first. Many will try to squeeze you in for a same-day appointment for urgent needs. Even if it is after hours, many doctors’ offices have an after-hours number to call that is answered by a nurse or doctor on call. Additionally, many plans covered by BCBSTX include our 24/7 Nurseline and MDLIVE as an option. You can give the details of the problem, and they will tell you where to go, or can call in a prescription if needed. If they think you need to go to the emergency room, they can call ahead to give the emergency staff instructions on what to do when you arrive.

And remember – for routine care, visit your doctor in your plans network. HMO members, be sure to see your Primary Care Physician.

• Path 2: Retail Health or Convenient Care Clinic
  It’s after hours. Your doctor’s office is closed, and that ear pain you’ve been dealing with is getting worse. So where do you go to have a minor medical problem looked at after hours by a medical professional? Walk-in clinics can be a wise choice for diagnosing everyday illnesses such as athlete’s foot or minor back pain. And retail health clinics even provide some immunizations and physicals. In addition to offering convenient locations, they offer retail hours with some locations offering 24-hour prescription services. Costs are generally lower than an urgent care center or an ER, so it’s really a great choice when you cannot get in to see your doctor. And, wait times are less than ER facilities, usually about an hour.

Use Provider Finder to see if there is one near you by selecting "Retail Health Clinics" from the “Provider Type” dropdown.

• Path 3: Urgent Care Center
  It’s a holiday weekend, your doctor is unavailable, and you’re faced with a medical problem needing immediate care. Where do you go when you don’t think it is serious or life-threatening? Urgent care centers can provide care for the days and hours that primary care physicians and retail health centers are closed. They provide easy access to health care when your illness or injury does not pose an immediate threat to your health or life. Urgent care centers can provide care for medical conditions that you do not consider an emergency but need attention before you can see your doctor.

Being knowledgeable about your options can make a big difference. We recognize that controlling health care costs for individuals is a complex matter. We offer ways on how to control your costs and care at the right place and the at the right time on our BCBSTX website.