No matter how careful — or how healthy — you are, it’s inevitable that at some time you’re going to have an incident that requires a visit to the doctor. Whether it’s a sprained ankle from a weekend ball game, a nicked finger from gardening, or a fall while doing home repairs, there’s no way to know when such injuries could happen. But the good news is that you can be prepared and know where to seek treatment.Patients should educate themselves as to the various healthcare options available in their community,” advises Alan Ayers, vice president of corporate development for the Addison- based Concentra Urgent Care and board director of the Urgent Care Association of America.“When a need arises, a call to a patient’s insurance company is a good starting point. Many insurance companies offer telephone help lines or online decision guides as to which type of facility is most appropriate for a patient’s symptoms,” Ayers says.Patients have three main options when it comes to medical treatment: a primary-care physician, an urgent-care center, or an emergency room.“If you need care fast and your primary-care doctor is unavailable, an urgent-care center can provide assistance for minor illnesses and treatments,” explains Dr. Aaron Braun, medical director of SignatureCare Emergency Center in Houston. He says that one of the main differences between treatment options is the hours. Both urgent-care centers and emergency rooms have longer hours than a traditional doctor’s office, but an emergency room is open around the clock.“If you are experiencing a medical problem in the middle of the night, an emergency room will be able to treat you,” says Braun.Treatment Checklist:Knowing which conditions are appropriate for each type of visit can save you both time and money — which is one reason it’s always a good idea to get your insurance company’s recommendation first. But Ayers and Braun say that certain injuries can easily be identified as emergencies.“If you’re experiencing symptoms such as heavy bleeding, large wounds, chest pains, burns, abdominal pain, head injuries, difficulty breathing, or broken bones, you should go to an emergency room,” Braun advises. “If you go to an urgent-care center with significant injuries, you could be costing yourself time. An emergency room can substitute for an urgent-care center, but not the other way around.”If the condition is not urgent and requires the doctor to know your health history, Braun says it’s best to see your primary-care physician. Minor injuries that don’t need immediate treatment, physical exams, common colds, and follow-up treatments are all good reasons to see your primary-care physician. So are problems related to chronic conditions such as diabetes and hypertension.“There are a few things to consider, such as do you need care right now, or is it something that can wait to see your primary- care doctor? What is the severity of your condition, and does it qualify as an emergency?” Braun adds. He advises that assessing your symptoms and asking yourself these questions will help determine what type of treatment to seek.An urgent-care center is a great option — even during your doctor’s normal business hours — if it’s something that can’t wait for an appointment, such as cuts, sprains, sports injuries, or a high fever.“Compared to primary-care offices, urgent-care centers have more advanced diagnostic capabilities, including on-site X-rays and laboratories. They can also perform procedures not typically done in a doctor’s office, such as stitching cuts and setting fractures,” Ayers says.If you’re unfamiliar with a particular facility, he suggests looking at reviews on Google or Yelp to see what former patients say about it or getting referrals from friends and neighbors.What to Know Before You Go:If it’s a weekend or after hours, and it’s a non-life-threatening case that needs treatment fairly quickly, you’ll most likely choose to visit an urgent-care center. Ayers says to check in advance to be sure the urgent-care center will accept your insurance, Medicare, or Medicaid. If you’re uninsured, ask about cash- pay discounts and get an estimate on what it will cost, as most centers will expect payment from uninsured patients before they leave the facility.“Many urgent-care centers can provide a price estimate or range prior to the visit.”With healthcare costs rising, and most primary-care doctors and urgent-care centers requiring payment on the spot from uninsured patients, it’s more important than ever to make sure you have adequate health insurance. Your Texas Farm Bureau Insurance Agent can help you find a plan that suits your needs through Blue Cross Blue Shield, including family and individual health plans. Health insurance will give you the peace of mind knowing that you can get the care you need, when you need it, at an affordable price.Keep in mind that where you choose to get treatment will greatly affect how much you pay — even when insurance is involved. A visit to your primary-care physician or an urgent-care center is typically covered by your insurance co-pay. Upfront costs to a private physician can vary depending on the services needed, and the average cost of an urgent-care visit is between $150 and $200 for an uninsured patient, Ayers says. Your co-pay may be anywhere from $20 to $60 depending on your plan, but always check with your insurance company first and know what your out-of-pocket expense will be.Emergency room visits are much more expensive, as they are intended for trauma and have a much higher overhead.“When a patient uses an emergency room visit for a routine or minor medical issue, they are paying for the availability of services not needed for that condition,” Ayers explains. That means the same visit that would cost around $200 with a family doctor or at an urgent-care center may cost more than three times that in an ER — and co-pays, if they cover the visit at all, will typically be around $100.Ayers reminds that since emergency rooms must treat the most urgent needs first, a visit to the ER with a condition like a sprain, minor cut, or cold/cough could result in a wait time of several hours.
