Urgent Care Vs Emergency Care – A Difference You Must Know

The difference in emergency care and urgent care is simple. If you believe that you are in a life-threatening condition and access to health care is critical for your life, you need emergency care. On the other hand urgent care service is needed when you think you need immediate medication attention but are not in a life-threatening condition. There is a fine line of difference in the two conditions. The following examples will help you to understand what kind of medical attention you need in different situations.

Examples of Emergency Room situations:

  • If you are in an accident and are badly injured you need emergency care. You should call 911 if you are conscious and quickly state the nature of your emergency.
  • If you have a heart attack or stroke symptoms (usually starts with a chest pain) or other severe pain you need emergency care.
  • If you have lost consciousness you need emergency care.
  • If you have critically hurt yourself at home or work you need emergency care.
  • Other examples of emergency care situations are: profuse bleeding, no pulse, severe injuries to different parts of the body, difficulty in breathing, injury to the brain, eyes, etc.

Examples of Urgent Care situations:

  • If you develop urinary tract infections, have a minor broken bone, cut yourself on the finger, etc you need urgent care.
  • If you develop earaches, migraine headaches, sprains, etc you need to go to an urgent care facility.
  • If you are in any other non life threatening situation you need urgent care.

Learn more about Should You Go to Urgent Care or The Emergency Room, visit - Emergency Room Vs. Urgent Care

Medical Emergencies and HMO plan

Medical emergencies need immediate attention. You can call 911 and quickly state the nature of your medical emergency. Otherwise you can go to the nearest ER.

  • If you are covered with the HMO plan and are not admitted to the hospital you will have to pay the emergency room co-pay. Try to go to the emergency room of your medical group. If that is not possible notify your medical group and someone will co-ordinate with the hospital to give you health care. You should crosscheck how this will work at the time of purchasing insurance.
  • If you need urgent care, call your primary care physician immediately. He will guide you what action to take. If he is not available you should call the 24 hour customer service number of your medical group.

Medical Emergencies and PPO plan

  • If you have the PPO plan try to go to a hospital ER that is in your PPO network to incur less cost. Ideally your emergency room deductible will be waived and your PPO physician will be contacted immediately.
  • If you need urgent care you must go to the nearest urgent care facility that is covered by your insurance. The hospital/service provider will file a claim for you. If you have to go to a non-network service provider you will have to pay for the services received. Later you can file a claim with your insurance company. For this claim you must have all evidence of expenditures.

Deciding whether you need emergency care or urgent care can be confusing at times. Remember that the two points of distinction in getting these services can be as follows:

  • How soon do you need medical care ?
  • Is your situation a life-threatening one?