ER vs. Urgent Care: Know the Difference

HR & Safety

When you are injured or sick enough to require emergency care, you don’t want the cost of that care to prevent you from seeking medical help.

But there’s no ignoring the hefty price tag that accompanies a visit to a hospital emergency room.

If yours is a true emergency requiring a 911 call, the ambulance crew isn’t going to ask about cost or insurance—they’re going to take you to the nearest or the most appropriate ER as fast as possible. 

However, if your injury or illness isn’t life threatening but nevertheless requires immediate attention, your choice of service provider has a significant impact on the cost, and deciding where to go for the appropriate level of care can be confusing.

Avoiding Unnecessary Emergency Medical Costs

Holding down medical costs starts with understanding your insurance plan.
If you’re an employer, ask your insurer for documentation on what your plan will and won’t cover if you or your employees need immediate care.
For example, get clarity on your ER copay and coinsurance and on what the plan will cover if you’re not admitted to the hospital.
Your insurer can also tell you which area hospitals accept your insurance. You can then ask the billing department at your hospital of choice whether the ER doctors participate in your insurance plan.
And because most insurers cover medically necessary ambulance services, know how your plan defines that—typically, it means the patient is unconscious, bleeding heavily, or in severe pain.

While the emergency room can help care for any medical situation, it costs an average of three times more than a visit to an urgent care center.

The biggest single step your employees can take to reduce medical costs is to choose the right kind of medical facility for themselves and their children.
You can help them do just that by making sure they understand the differences between an emergency room and an urgent care facility.
While an emergency room can handle any medical situation, the average cost of an ER visit is approximately $2,300, according to industry data.
In comparison, the average cost of visiting an urgent-care center is $176.
In addition, in a non-life threatening situation, you can usually be treated at an urgent care center effectively and far more quickly than in an ER; typical wait times are significantly shorter in urgent care facilities.
Urgent care centers are usually staffed by at least one emergency medical physician, as well as physician assistants and advanced practice resident nurses. Many facilities have x-rays and labs onsite.
While hospital ERs are open 24/7, many urgent care centers are open late and on weekends and holidays.

Deciding Where to Go

Here's a brief guide your employees can use when deciding between an emergency room and an urgent care facility:
Visit an emergency room if you experience:

  • Allergic reactions to food or animal or bug bites
  • Broken bones, particularly large bones
  • Chest pain
  • Constant vomiting
  • Continuous bleeding
  • Severe shortness of breath
  • Deep wounds
  • Weakness or pain in a leg or arm
  • Head injuries
  • Unconsciousness

Visit an urgent care center if you experience:

  • Flu or a severe cold
  • Coughs and sore throat
  • High fevers
  • Earaches and potential eye infections
  • Vomiting, diarrhea, stomach pain
  • Cuts and severe scrapes
  • Minor broken bones such as fingers or toes
  • Minor injuries and burns

Getting the right care when needed always should be your priority. But with so many urgent care centers and walk-in clinics now available, making an informed choice can save employees thousands of dollars and help stem the continuing rise in healthcare costs that affect all of us.

If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company's next renewal. It’s free as part of your participation in CBIA Health Connections!


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