Get the care you need

Whether you’re managing an ongoing condition, a sudden injury occurs, or an unexpected illness arises, there’s a good chance that you’ll need to see a doctor sometime this year. Depending on what kind of symptoms you’re experiencing, you may or may not know where to turn for care — your primary care physician, a retail clinic, an urgent care center, the emergency room, or online via virtual care.

So, which should you choose? Here’s how to take control of your health to get the care you need.

First step: Understand your network
The type of health plan you choose determines the network of providers that you can visit. Doctors and hospitals in your plan's network are called in-network providers. Those not in your plan's network are out-of-network providers. While you can go to the emergency room regardless of your network, you should check if your doctor, urgent care center, retail clinic, or virtual care provider are in network. Review your plan’s directory ahead of time to know what providers and facilities in your area are in network since you could pay more out of pocket at an out-of-network location.

Next: Know your options — before you need them
When something is going on with your health and your primary care doctor isn’t available, you have other options that don’t involve a trip to the emergency room. Using virtual care, retail clinics, or urgent care centers when it’s not an emergency can save you a significant amount of time and money.

These lists are not exhaustive, but they can give you a general idea about what kind of care you can get in what place.

What can be treated via virtual care

For non-emergency care, virtual care appointments can be a cost-effective way to get help quickly and from home. Here’s what you can typically get treatment for either online or over the phone with a board-certified doctor:

• Allergic reactions (minor)
• Bronchitis
• Cold, cough, and flu
• Digestive issues
• Eye pain or irritation
• Fever
• Headache (minor)
• Sinus pain
• Skin conditions
• Sore throat
• Urinary tract infection
• Vomiting

What can be treated at a retail clinic

Retail clinics can treat many of the same symptoms that can be treated with a virtual care appointment. However, these facilities are a better choice when you are vomiting, have sinus pain, have a cut or scrape, or need to be vaccinated.

Here are some additional symptoms that can be treated at a retail clinic:

• Allergic reactions (minor)
• Bronchitis
• Burns (minor)
• Cold, cough, and flu
• Digestive issues
• Ear pain
• Eye pain or irritation
• Fever
• Headache (minor)
• Insect bites
• Sore throat
• Urinary tract infection
• Vaccinations

What can be treated at an urgent care center

If you’re sick or hurt, an urgent care center appointment can be less expensive than an emergency room visit. Some of the top reasons to head to an urgent care center: allergic reactions (that are minor), stitches, animal bites, and sprains.

Here are a few more symptoms that can be treated at urgent care:

• Asthma attack (minor)
• Back pain
• Broken bones (minor)
• Bronchitis
• Burns (minor)
• Cold, cough, and flu
• Digestive issues
• Ear pain
• Eye pain or irritation
• Fever
• Headache (minor)
• Infections
• Injuries (minor)
• Insect bites
• Sinus pain
• Skin conditions
• Sore throat
• Strains
• Urinary tract infection

When to head to the emergency room

If you’re experiencing a severe or life-threatening sickness or injury, head to the emergency room (ER) as soon as possible. This includes an overdose, signs of a heart attack or stroke, loss of consciousness, or a spine-related injury.

Here’s what else should be treated at the ER:

• High fever with a headache or stiff neck
• Major injury
• Poisoning
• Seizure
• Severe allergic reaction
• Sudden severe headache
• Suicidal thoughts
• Trouble breathing

You have options for getting care when you need it. Take a few minutes when you’re feeling good to carefully review your plan information for details on copayments and coinsurance amounts for each option. That way, if you need care fast, you’ll know what to expect ahead of time.