If You Have a Medicare Plan, Learn When to Go to the ER
A health scare can start without warning. You notice stomach pains. You fall and hurt your hip. Or the wrist you thought you simply sprained can no longer move. Nearly one-third of emergency department visits among adults over 65 result from an injury, according to the Centers for Disease Control and Prevention. Depending on the severity, some of these injuries may be able to be treated at an urgent care clinic. But how do you know when to go to the urgent care clinic or make a trip to the ER?
Urgent care is there to fill the gap between your doctor and the ER. Urgent care clinics stay open after normal business hours. This includes nights and weekends. The ER is open 24 hours a day, 7 days a week. You should visit the ER if you have severe or life-threatening injuries or illnesses. The ER has access to specialists and specific equipment that may be needed.
Depending on how serious your injury or illness is, you could end up waiting a long time to see a doctor in the ER. You’ll also end up paying more for the visit. Check your Medicare health plan’s Evidence of Coverage to find out what you’ll pay at the ER. If you don’t have it handy, you can call our Member Service team to find out what costs you’ll have if you end up in the ER.
When to visit an urgent care clinic:
- Ear pain
- Painful urination
- Sore throat
- Minor trauma such as a common sprain, minor burns or shallow cut
- Minor rashes
When to visit the ER:
- Broken and dislocated bones
- Convulsions, seizures or loss of consciousness
- Deep wounds
- Uncontrollable bleeding
- Moderate to severe burns
- Serious head, neck or back injury
- Severe abdominal or chest pain
- Severe difficulty breathing
- Loss of vision, sudden numbness, weakness, slurred speech, or confusion (signs of stroke)
Check your Medicare health plan’s Evidence of Coverage to find out what you’ll pay at the ER. If you don’t have it handy, click here and scroll down until you find the Evidence of Coverage for your plan. You can also call our Medicare Member Service team to find out what costs you’ll have if you end up in the ER.
Save time and stress: Get ready now in case of an emergency. If you need emergency care, you may not be able to let the medical team know how you’re feeling or what medications you’ve been taking. Take time now to make a plan in case of an emergency. Here are some tips you can use to make your plan.
- Have at least two emergency contacts in case one cannot be reached.
- Know the names of your doctors
- Make a file with your Identification information, list of medications, allergies and insurance information.
- Make sure your caregiver or loved ones know your medications and have access to paperwork they might need.
- Ask questions! If you don’t understand something, speak up and get the information you need.
- Remember, in the event of an emergency call 911.
Filed under: Medicare