Emergency room or urgent care? Understand the differences and costs

EDINA, Minn. – You slipped on the stairs and feel your ankle throbbing. Your cough has lasted all month. Or your child spikes a high fever in the middle of the night. You call your primary care doctor first, but you can’t get a same-day appointment. So do you go to the emergency room or urgent care?

When these situations occur and people need immediate care, many face uncertainty due to the number of options available – and where they choose to go for help could be the difference between paying hundreds or thousands of dollars. In fact, rushing to the emergency room for non-life-threatening ailments may cost patients nearly 10 times more than visiting an urgent care center.

Consider these things when deciding where to go for care.

Urgent care centers are not for emergencies but can help people when they need care quickly. If they can’t get in with their primary care physician, an urgent care center is a great option. Remember, it’s first-come, first-served. Consider urgent care if the patient has symptoms such as a fever without a rash, moderate flu-like symptoms, sprains and strains or small cuts that may require stitches.

The average cost for an urgent care visit is $170; however information about treatment costs are estimates and reflect the average costs of guidance and care delivered through UnitedHealthcare owned and contracted service providers to members of UnitedHealthcare health plans. Costs for specific guidance and treatments may be higher or lower than the costs represented here.

The hospital emergency room provides medical care day or night. If the patient’s condition requires fast and advanced treatments, like surgery, go to the emergency room. The emergency room helps people with life-threatening or dangerous conditions first. Some of the symptoms that require an emergency room visit include, but are not limited to chest pain, numbness, slurred speech, fainting, serious burns, concussion, broken bones and dislocated joints, fever with a rash and seizures.

The average cost for an emergency room visit is $2,000. Emergency room cost estimates include facility charge and initial physician consultation, but may be higher or lower based on a number of factors.

Dr. Robert Kantor, market chief medical officer for UnitedHealthcare, urged people to take a moment to think through their symptoms before rushing to the emergency room.

“It’s a difficult situation when you’re experiencing it,” he said. “Your mind is not always so clear.”

Consider a virtual visit, instead.

According to a National Center for Health Statistics study, 48% of patients who went to the emergency room but were not admitted said they chose the emergency room because their doctor’s office was not open.

If faced with a non-emergency health condition – like a migraine, sore throat or stomachache – but the doctor’s office is closed, consider a virtual visit. It allows patients to chat face-to-face with a doctor, day or night, and can save them up to $2,000 when compared to a visit to the emergency room.

Check your official health plan documents to see what services and providers are covered by your health plan. Virtual visits are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times or in all locations.

The average cost for a virtual visit are $50 through United Healthcare, according to the health insurance company.

Also, many health insurance companies have a 24-hour nurse line that can help patients with decisions like where to go for care. They can also compare quick care options with UnitedHealthcare’s online resource. If someone is experiencing life-threatening symptoms other than those listed, go to the emergency room or call 911.

Submitted by UnitedHealthcare.