‍Note: If you or someone in your care is experiencing a potential medical emergency, stop reading and dial 911.

Your primary care doctor is the best option for non-emergencies

‍Cost: $$

Wait time: Until an appointment is available

When cold and flu season hits, pin your doctor’s contact info on the fridge. Your primary care physician, the one you see for annual checkups and bloodwork, is your first line of defense against pesky coughs, viruses, allergies, minor injuries, and every other non-urgent condition. They already know your medical history in full. They’re better equipped to provide customized care than an urgent care doctor who’s seeing you for the first time.

While your exact coverage depends on your health insurance policy, visiting your PCP (primary care provider) is almost always the most affordable option with the lowest co-pay. The downside of visiting your PCP is that most doctors today are extremely busy. Getting a last-minute appointment can be a challenge.

Luckily, HealthBird offers a digital appointment booking through an app, so you don’t have to call to the doctor’s office and wait in line.

If a cough is keeping you up all night, you may want to skip the wait and head to an in-network urgent care.

‍You should see your doctor if:

• Your condition isn’t urgent
• They have same-day or next-day appointments available
• You’re being treated for a prolonged condition

Urgent care is a good option if you can’t reach your doctor

Cost: $$$

Wait time: Typically first come, first serve

Whenever your doctor’s office is closed or fully booked, head to urgent care. Urgent care centers are easily recognizable by names like MD Now urgent care, Nextcare urgent care, Wellnow urgent care, and Fastmed urgent care. Are you sensing a theme? Most urgent care centers, including urgent care for kids, provide timely care for a wide variety of non-life-threatening conditions, including:

• Colds, flus, and coughs
• Sprains and pulled muscles
• Fevers
• Headaches
• Vomiting and diarrhea
• Abdominal pain
• Ear, sinus, and urinary tract infections
• Rashes
• Minor cuts that may require stitches
• Minor eye injuries
• Minor fractures

If you’re not sure when to go to urgent care vs. PCP, it mostly comes down to availability and convenience. When your head is pounding or you can’t sit up without getting queasy, the less time spent in a waiting room the better. Urgent care wait times vary, but some centers now offer an online check-in option to speed up the process.

Some clinics may not offer x-ray services, but most do. If an x-ray shows a more serious break or sprain, the urgent care physician will refer you to the ER instead. If you’re not sure if your condition can be treated at urgent care, call or drop in and ask. Based on your symptoms, they’ll be able to tell you which option is a better fit.

Are walk-in clinics the same?

Almost, but not quite. Some large pharmacies and retail stores offer convenient walk-in clinics to treat simple conditions. A MinuteClinic, like those found in some CVS stores, is best for adults with minor symptoms. They’re often staffed by nurse practitioners and physician assistants, however, so they can’t treat as many conditions as a full-service urgent care center.

Retail health clinics are a good choice for alleviating cold and flu symptoms, ear infections, and minor skin conditions, plus getting vaccinations or boosters. The biggest benefit of these clinics is that no appointment is required, and wait times are usually minimal.  

You should go to urgent care if:

• Your PCP is fully booked
• You need care outside of typical office hours
• You have a minor, non-life-threatening illness or injury

For potentially serious conditions, head to the emergency room, stat

Cost: $$$$

Wait time: Potentially long, with serious conditions given priority

ER copays are the most expensive, so don’t visit the emergency room if you just have an unpleasant stomach bug, light fever or a bad sore throat. Emergency care is for just that: Emergencies.

If you’re experiencing what could be a medical emergency, the emergency room is a no-brainer, but what counts as an emergency?

As a rule of thumb, if a person could die or become disabled due to an illness or injury, it counts as an emergency. If the risk is immediate, dial 911. Conditions that warrant a 911 call include, but are not limited to:

• Choking
• Being unable to breath
• Severe chest pain or pressure
• Serious head injuries that result in confusion or fainting
• Neck or spine injuries
• Severe burns or electric shocks
• Severe bleeding
• Seizures, especially those lasting over a minute
• Sudden weakness or drooping on one side of the body
• Suddenly loss of sight, vision, or ability to move

Other conditions may be serious enough for an emergency room visit, but not so serious that you need help to come to you. Possible broken bones, deep wounds, burns, severe pain, high fevers, potential poisoning or drug overdose, allergic reactions, and sudden, severe headaches are examples of conditions that warrant a trip to the ER.

You should go to the ER if:

• Your PCP and local urgent care center is closed
• You’re in severe pain or discomfort
• You may be experiencing a medical emergency

Again, if there’s any shred of doubt, go dial 911. You know the phrase “better safe than sorry?” In this case, it’s more like better safe than dead. The higher copay and uncomfortable wait is worth it if it saves your life.

Unclear what your insurance covers with either of the visits?

Don't hesitate to give us a call at (833) 384-2473 or email hello@healthbird.com. Our team of Licensed Team at HealthBird is always available to delve into your account details and offer you the dedicated support you need. We're here to ensure you have all the answers for your insurance queries.

Not sure which option is the right choice? Ask a nurse 24/7!

Still stuck trying to decide between PCP vs urgent care, or urgent care vs ER? Health hotlines are available around the clock to help you make a quick, informed decision. Most insurance companies offer their own nursing hotline, so check with your provider to get remote guidance in minutes.

Whether you end up at a 24-hour urgent care or the emergency room, you’ll likely have prescriptions to fill after the fact. Even if you’re fully insured, consider using HealthBird’s FREE Rx card to save on generic medications and some over-the-counter drugs.