Urgent care centers are popping up everywhere. And retail clinics are in drugstores and supermarkets. That makes it easier than ever to get the care you need when you need it. But how do you know if it’s okay to wait a day or two for an appointment with your doctor? Or whether you should go to a retail or urgent care facility — or rush to the emergency room (ER)? 

Each one offers a different level of care and expertise. Understanding the differences can help you make the best decision and get the care you may need. The right choice can also save you time and money. Here’s a simple flowchart about when to visit your primary care provider (PCP), urgent care or the emergency room.

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Step 1. Do you have a life-threatening condition?

a. Yes: Go to the Emergency Room (ER) or call 911 if you have slurred speech, chest pain, difficulty breathing, uncontrollable bleeding, major broken bones, a head injury, sudden loss of vision or numbness, seizures, or other symptoms of serious and life-threatening conditions.

b. No: Proceed to the next step.

Step 2. Can you wait to see your primary care provider (PCP)?

a. Yes: Contact your PCP for non-urgent needs such as managing chronic conditions, medication refills, illnesses like a cold or routine physicals. 

b. No: Consider the following options when you need fast treatment for a non-critical issue:

Step 3: When you need fast treatment for a non-critical issue

a. Retail clinic: Visit for minor ailments or things your PCP can’t do over the weekends or after business hours. This may include cold and flu symptoms like a sore throat, blood pressure checks, medication refills, immunizations and minor injuries like a sprained elbow. Some retail clinics also have a specialty area, such as optometry, orthopedics or mental health.

b. Urgent care: Go for a fever, nausea, fractures, stitches, rashes and other urgent conditions that don’t require the ER. Urgent care clinics have a doctor on staff and can often diagnose and treat patients. 

c. 24-Hour Nurse Line: Our team of licensed nurses can help you with nonurgent health concerns or tell where to go for care. Call them anytime at 1-855-493-7019 (TTY: 711).

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. 

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