Use the Emergency Room for True Emergencies
Most of us have a “get-it-now” mentality. But when it comes to healthcare, that mindset can cost you extra money, especially when using the emergency room (ER) for routine care, such as a cold or flu, earache or sore throat. ERs are designed when life-or-limb-saving care is needed immediately. Here is a partial list of true medical emergencies:
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Ongoing chest pain, especially if it goes down your arm or to your jaw or is accompanied by sweating, vomiting or shortness of breath
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Persistent shortness of breath or wheezing
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Severe pain, particularly in the abdomen or starting halfway down the back
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Loss of balance or fainting
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Difficulty speaking, altered mental status or confusion
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Weakness or paralysis
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Severe heart palpitations
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Sudden, severe headache
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Sudden testicular pain and swelling
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Newborn baby with a fever
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Intestinal bleeding
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Falls with injury or while taking blood thinning medications
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Loss of vision
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Head and eye injuries
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Broken bones or dislocated joints
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Deep cuts that require stitches – especially on the face
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Head or eye injuries
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Severe flu or cold symptoms
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High fevers or fevers with rash
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Bleeding that won’t stop or a large open wound
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Vaginal bleeding with pregnancy
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Repeated vomiting
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Serious burns
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Seizures without a previous diagnosis of epilepsy
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Your Cost for Using the ER
How much you pay to use the ER depends on your specific plan’s cost-share arrangement and where you are in meeting your annual deductible. You will be responsible for any of your deductible you have not yet met, a significant copay amount (from $250 to $500) and your coinsurance. These costs are waived if you are admitted into the hospital. Check your CoOportunity Health member ID Card to determine your cost-share arrangement.
Other Options for After-Hours Non-Emergencies
Many areas have urgent-care clinics to treat health issues when the doctor’s office is closed or doesn’t have any available appointments. Urgent-care clinics are walk-in clinics that can handle conditions that need to be treated right away but aren’t emergencies. Some symptoms that can be treated at urgent-care clinics include:
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Fevers without rash
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Sprains
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Painful urination
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Persistent diarrhea
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Severe sore throats
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Vomiting