Feeling sick? Know where to go

Published April 21, 2014

If you’re one of the millions of Americans with a new Blue Cross Blue Shield health insurance plan, congratulations!  You’ve successfully enrolled with the oldest and largest health insurance network in America and can enjoy the security of unparalleled access to quality, affordable healthcare.  But what happens next?

The answer is putting your insurance to use.  We know you don’t expect to get sick, or anticipate an accidental injury or life-threatening health event, but when an ailment strikes knowing where to go can help relieve some of the worry and stress.

There are three places available for you to seek care: your physician’s office, an urgent-care or walk-in clinic, or the emergency room.  Below, The Blues® offer some guidance on how to determine the right destination for your treatment needs.

Physician’s Office is First Choice

“I can’t say it enough. Having a relationship with a personal physician is the most important thing you can do for your health,” says Dr. Tim Gutshall, family physician and chief medical officer at Wellmark Blue Cross and Blue Shield.   According to Gutshall, if you don’t have a personal physician, make it a priority to find one.

“You should be able to talk to your personal physician about anything. Don’t hesitate when it comes to calling your personal physician in urgent care situations. Your physician’s office or on-call service is trained to guide you through these events. It’s one of the main benefits of having a physician who knows you.”

When Time is of the Essence, Go to the Emergency Room or Call 911

If you feel it’s an emergency, act quickly – don’t hesitate. Go to the emergency room or call 911. In some cases, such as a stroke or heart attack, delays in treatment often lead to more serious consequences.

It may seem obvious, but emergency rooms are not the place for routine care. However, every year millions of Americans use the emergency room for routine medical care. They face long waits for care they could receive more quickly in a physician’s office.

What's more, you'll pay far more out-of-pocket for emergency room care. Office visit copayments or coinsurance typically cost around $10-$30. Emergency room copayments or coinsurance will cost you far more, likely between $100-$300.

If you feel your condition doesn’t require the emergency room, call your personal physician or go to a walk-in clinic or urgent care center.  Some Blue Cross and Blue Shield companies also offer a toll-free 24-hour nurse line, which you can find on the back of your member card, or by visiting your BCBS company website.