What’s the Difference Between Urgent Care and the ER?
Though their names are similar, urgent care and emergency room treatment are two different ways of getting healthcare. It’s important to understand the differences if you want to make the best decision during your next urgent health issue.
Urgent Care vs. ER: The High Level
Urgent care and emergency facilities are two different medical/healthcare establishments. Both are capable of treating a wide variety of illnesses and conditions, but are equipped with different resources and different kinds of personnel – and they function very differently when it comes to billing and insurance.
Let’s take a look at the individual differences that differentiate these forms of care.
Health Issue Severity
The most important difference to understand between an urgent care facility and an emergency room is this severity of the health issues that each facility tends to treat. Hospitals and emergency rooms are typically designed to treat only the most severe, significant, and urgent issues. If your life is in danger, if your body has suffered major damage, or if you need imminent treatment, an emergency room is your best choice.
But what if your issue doesn't require emergency treatment? Generally, if you can afford to wait a few days or a few weeks, you're best off visiting your primary care physician. Your primary care physician can give you a full evaluation with an appointment, and direct you to see someone else if necessary. If you have a very mild rash that doesn't hurt or bother you, or if you have mild stomach aches from time to time, a primary care physician is your best bet.
But what happens if your health issue falls somewhere in between? What if it's more urgent than a mild rash but less urgent than cardiac arrest?
This is where urgent care centers truly shine. Urgent care centers are designed to tackle health issues that are severe enough to warrant near-immediate attention, but aren't appropriate for an emergency room. Urgent centers typically treat issues like fever, earaches, dehydration, minor allergic reactions, cuts that require stitches, small fractures, stuck foreign objects, and minor injuries.
Hours and Staffing
There are differences in both hours and staffing for urgent care and ER facilities as well.
The ER is staffed constantly with an assortment of physicians, specialists, nurse practitioners, nurses, and aides. While urgent care staffing varies from facility to facility, these institutions are usually staffed with nurses and nurse practitioners as their main personnel. Physicians and specialists may or may not be available – but rest assured, the people working at urgent care are more than capable of handling most potential issues.
The emergency room is typically open and available 24/7. If you need medical attention immediately, it will always be accessible to you. Urgent care centers, in contrast, operate on a fixed schedule – though their hours are usually generous.
Billing and Insurance
It's also important to understand major differences between urgent care and the ER when it comes to billing and insurance. As you might imagine, the ER is typically much more expensive than an urgent care visit, while an urgent care visit is more expensive than a visit to your primary care doctor.
If your insurance company deems your visit to the ER unnecessary or unwarranted, they may deny to cover any of the costs of your visit. Additionally, if the emergency room isn't owned by a hospital, or if the ER is out of your network, you may run into financial and insurance complications as well.
As long as your urgent care facility is in-network, you'll probably only have to pay a copay. Always verify the details of your insurance policy, since insurance coverage varies.
When Should You Call 911/Go to an ER?
So when should you call 911 or go to an emergency room instead of relying on urgent care?
- Choking or cessation of breathing. If someone is choking or unable to breathe, they need immediate attention.
- Significant head, neck, or back injuries. Major injuries to the head, neck, or back can lead to long-term consequences if not treated right away.
- Severe chest pressure or pain. This could be a sign of a major cardiac event.
- Electric shock. Being electrocuted or struck by lightning often requires emergency medical treatment.
- Severe burns. The same is true of severe burns.
- Seizures. If seizures last 3 to 5 minutes or recur frequently in a given period, you should seek emergency treatment.
- Other imminent threats to life. Anything that can be considered an imminent threat to life should be treated at an emergency room.
For almost everything else, urgent care is the highest priority care you should seek. Going to urgent care instead of an emergency room helps conserve resources for the people who need them, saves you money, and in many cases, provides you with better, more appropriate care.