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Know where to go
WHERE
YOU CAN WHEN TO GO TYPE OF CARE 1 COST AND WAIT TIMES 2
GET CARE
Doctor’s When you need a preventive Routine checkups Often requires a co-payment
Office exam or treatment for a current Immunizations and/or co-insurance
health issue, your doctor’s Normally requires an
Preventive services
office is the best choice. Your appointment
doctor can help you manage General health Little wait time with scheduled
your medications and refer you issues
appointment
to a specialist.
Convenience You can’t get to your doctor’s Common infections Often requires a co-payment
Care Clinic office, but your condition is (e.g., strep throat) and/or co-insurance similar to
not urgent or an emergency. Minor skin conditions office visit
Convenience care clinics, often (e.g., poison ivy) Walk-in patients are welcome
located in malls or retail stores, with no appointments
Flu shots
offer services for minor health necessary, but wait times
conditions. Care is normally Pregnancy tests can vary
provided by nurse practitioners Minor cuts
or physician assistants. Earaches
Urgent Care You may need care quickly, Sprains Often requires a co-payment
Center but it is not an emergency, and Strains and/or co-insurance usually
your regular doctor may not be Minor broken bones higher than an office visit
available. Urgent care centers (e.g., finger) Walk-in patients are welcome,
offer treatment for non-life- but waiting periods may be
threatening injuries or illnesses Minor infections longer as patients with more
and are staffed by qualified Minor burns urgent needs will be treated first
physicians.
Emergency You need immediate treatment Heavy bleeding Often requires a much higher
Room (ER) for a very serious or critical Large open wounds co-payment and/or co-insurance
condition. The ER is for the Sudden change Open 24/7, but waiting periods
treatment of life-threatening in vision may be longer because
or very serious conditions that patients with life-threatening
require immediate medical Chest pain emergencies will be treated first
attention. Do not ignore an Sudden weakness If you are in a true medical
emergency. If you have a life- or trouble talking emergency, and you go to
threatening situation, call Major burns a network or out-of-network
911 or your local emergency Spinal injuries emergency room for care, the
phone number right away.
Severe head injury same co-payment and co-
insurance levels will apply.
Difficulty breathing
However, you may incur higher
Major broken bones
out-of-pocket costs if you go to a
provider outside of your network.
Finding care when you are traveling. Call the member phone number on your ID card
to find providers near you, and to learn if any restrictions apply.
1 This is a sample list of services and may not be all-inclusive. 5
2 Cost and time information represent averages only and are not tied to a specific condition, level of coverage or treatment. Your out-of-pocket costs will vary based on plan design.
