Urgent Care vs. Emergency Room: When to Go & Which One to Choose | RMHP Blog

By RMHP

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Knowing the Differences Between Urgent Care and Emergency Room saves lives and dollars 

It’s tricky to decide whether to visit an urgent care clinic or the emergency room (ER) when you or someone in your family is injured or falls ill. Each facility offers different types of care and services. Understanding when it’s a good idea to visit urgent care can lead to substantial savings for patients. 

When should I go to the emergency room?

In the event of a life-threatening illness or injury, call 9-1-1 or get to the ER immediately. Trust your gut. “If your personal instinct or your motherly intuition tells you it’s serious, don’t hesitate — go to the nearest emergency room,” says Shawn Evans, MD, an emergency medicine doctor interviewed by the hospital at his place of employment. 

The emergency room should be your first stop in the event of any of the following symptoms or experiences:

  • Chest pain or pressure
  • Difficulty breathing
  • Coughing or vomiting blood
  • Uncontrollable bleeding or severe trauma (badly broken bones/serious cuts)
  • Severe head trauma and/or injuryLoss of consciousness
  • Disorientation or difficulty speaking
  • Sudden and/or severe pain
  • Sudden dizziness, changes in vision, or weakness
  • Sudden changes in mental abilities, especially marked confusion

This short list isn’t comprehensive, so remember Dr. Evans’ advice: Trust your instincts. 

Understanding how your health insurance covers ER visits

You should know which in-network emergency room is closest to your home before the need to visit ever occurs. Check with your insurance provider to confirm in-network hospitals and what’s covered under your plan. When an emergency strikes, you’ll already know exactly where to go and what to expect. 

When should I go to urgent care?

Urgent care clinics have longer evening and weekend hours, making them a flexible option for medical care. They treat a variety of conditions that aren’t life-threatening, but still require professional medical attention. Doctors and nursing staff can treat things like minor injuries, injections, and illnesses. Symptoms and illnesses that merit a trip to urgent care include:

  • Cold and flu
  • Fever 
  • Earache
  • Headache
  • Cough and/or sore throat
  • Urinary tract infections
  • Animal bites
  • Minor sprains
  • Joint and body pain
  • Mild asthma

Essentially, urgent care facilities offer many of the same services as a primary care physician, including blood work, lab services, vaccinations, and stitches.

Understanding how your insurance covers urgent care and emergency room visits

When you confirm ER copays and coverage, check how your insurance policy handles urgent care visits. Copays tend to be lower for urgent care than they are at ER facilities.

RMHP Members can confirm coverage by calling at 970-243-7050 or drop by our office at 2775 Crossroads Boulevard in Grand Junction with any questions. Whether you call or visit, our team is available Monday through Friday from 8 a.m. to 5 p.m. MST.

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