Know your options before you go to the ER, UnitedHealthcare will help you understand when to go to the ER vs. Urgent Care and other fast professional care alternatives. +The Emergency Room copay is waived if the patient is admitted to the hospital.If you fail to call, you will be responsible for paying 50% of the amount allowed or $250, whichever is less. You will also be responsible for the applicable copay or, if you used a non-par.
Emergency Room Copayment Waiver Request. UnitedHealthcare Medicare Advantage. CO-1315M REV 3/2020. This form must be completed by a retiree seeking a waiver of an Emergency Room Copayment. Submit this form to UnitedHealthcare. You must provide. John severely cuts his leg and goes to the closest emergency room (ER). The ER doctor is out-of-network. See how much more he may have to pay compared to a network provider. Emergency room doctor Network doctor Out-of-network doctor A. Billed charge amount $2,000 $2,000 B. Eligible expense $600. $600 C. John’s responsibility.
You slipped on the stairs and feel your ankle throbbing. Or your child spikes a high fever in the middle of the night. You call your primary care doctor first, but you can't get a same-day appointment. So do you go to the emergency room (ER) or urgent care? Or would a virtual visit work best?
If it’s not actually an emergency situation, rushing to the ER for non-life threatening ailments may cost patients far more than visiting a more appropriate care setting. In addition, seeking care in the ER may mean longer wait times and an increased exposure to germs, plus potentially unnecessary tests or treatments. Using the ER for all your health care needs may also mean you’re missing an opportunity to create a long-term relationship with a primary care physician who can provide preventive care before more serious issues arise.
That’s why understanding the most appropriate care setting is an important step to help you receive the simplest experience with the best outcomes.
Here’s what to consider when deciding where to go for care:
Urgent care center
Urgent care centers are not for emergencies but can help you when you need care quickly. If you can’t get in with your primary care physician, this may be another option. Remember, it’s first-come, first-served. You may consider urgent care if you have symptoms like the following:
- Fever without a rash
- Moderate flu-like symptoms
- Sprains and strains
- Small cuts that may require stiches
The average cost for an urgent care visit is $180*.
Emergency room
The hospital emergency room provides medical care for life-threatening injuries or illness. While some people may be tempted to utilize ER services because it’s open 24/7, the wait time is typically two hours on average. Patients with life-threatening emergencies or critical conditions will be treated first so if you’re experiencing a minor ailment, it may not be the best place to seek care. Some of the symptoms that require an emergency room visit include, but are not limited to:
- Chest pain
- Numbness
- Slurred speech
- Fainting
- Serious burns
- Concussion
- Broken bones and dislocated joints
- Fever with a rash
- Seizures
The average cost for an emergency room visit is $2,200*.
Have you considered a virtual visit?
If you are faced with a non-emergency health condition – like a migraine, sore throat or stomachache – but your doctor’s office is closed, you may consider a virtual visit. This allows you to virtually chat face-to-face with a doctor, day or night, and may help you save money compared to a visit to the ER**. Virtual visits – along with telehealth resources increasingly available through local health care providers – are especially important for medical advice related to the on-going COVID-19 situation.
Tricare Emergency Room Copay
The average cost for a virtual visit is less than $50*.
Still not sure?
UnitedHealthcare plan members can also compare quick care options with UnitedHealthcare’s online resource, as well as use a symptom checker to help with your COVID-19 concerns. If you or a loved one are experiencing what you feel to be life-threatening symptoms other than those listed, go to the emergency room or call 9-1-1.
*Information about treatment costs are estimates and reflect the average costs of guidance and care delivered through UnitedHealthcare owned and contracted service providers to members of UnitedHealthcare health plans. Costs for specific guidance and treatments may be higher or lower than the costs represented here. Emergency room cost estimates include facility charge and initial physician consultation.
Florida Blue Emergency Room Copay
**Check your official health plan documents to see what services and providers are covered by your health plan. Virtual visits are not an insurance product, health care provider or a health plan. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times or in all locations.