ER versus Urgent Care

Posted on: Fri, 11/07/2008 - 5:16am
Ra3chel's picture
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Joined: 01/21/2008 - 12:28

Ugh. So, my (work-based) health plan just upped the copay for emergency rooms from $50 to $200, nominally to stop people from using them "casually." At the company meeting to discuss this, the insurance rep went on and on about how we should only go to them for things that absolutely can't be treated at Urgent Care.

The couple times I've had anaphylactic reactions, I've gone straight to the ER (as directed). I have no idea whether a Urgent Care clinic is a viable alternative. If it's not, yeah, I'll go to the ER if I have a reaction, but I'd just as soon be able to respond without freaking out over whether I can afford a ludicrous copay.

Does anyone know about / have experience with this?

Posted on: Fri, 11/14/2008 - 1:23pm
cristym's picture
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Joined: 11/19/2007 - 17:26

When I was in college I had what I would later find out was an anaphylactic reaction to medication. The health clinic at the school told me that if I had not been in such bad shape they would have had me transfered to the ER. I think I would personally go straight to the ER, but it would be worth stopping in or calling the Urgent Care (before you have a reaction) and seeing what their policy is on someone who has a history of ana reactions ... they may require that a patient goes to the ER.

Posted on: Fri, 11/28/2008 - 6:38am
4mykids's picture
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Joined: 09/01/2008 - 09:15

I am sorry about your co-pay.
Our insurance will waive the ER co-pay if you are actually admitted to the hospital from the ER, which could be the case since you should be watched for 24 hours. My daughter was admitted when she had an accidental peanut ingestion with anaphylaxis so we did not have a co-pay. Thankfully our insurance covers hospital 100%, if you only get 80/20 it may not help you.
Check your written insurance plan or call customer service to find out.

Posted on: Fri, 11/28/2008 - 1:44pm
cathlina's picture
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Joined: 06/29/2001 - 09:00

If you are having an ana reaction...plz go to the ER. Urgent care type offices will NOT have all the meds for allergic reactions. Also, (heaven forbid) if the reaction progresses and you would need a tracheotomy or a respirator....you need to go the ER.
I do know of one case where a person ate some shellfish, started feeling funny and DROVE(?) 40 miles to his doctor's office (even though he was near an hospital had an ER in a small town and collapsed at the front desk. Luckily, my family doctor recognized what the problem was and gave him an epi.

Posted on: Thu, 12/11/2008 - 8:25am
Ra3chel's picture
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Joined: 01/21/2008 - 12:28

Originally Posted By: 4mykidsI am sorry about your co-pay.
Our insurance will waive the ER co-pay if you are actually admitted to the hospital from the ER, which could be the case since you should be watched for 24 hours. My daughter was admitted when she had an accidental peanut ingestion with anaphylaxis so we did not have a co-pay. Thankfully our insurance covers hospital 100%, if you only get 80/20 it may not help you.
Check your written insurance plan or call customer service to find out.
Oh, I already know they'll waive the copay if you're admitted, 'cause last summer I ended up in the ER with appendicitis.
However, I've been in the ER a couple times for allergic reactions, and I've never been admitted / kept overnight.

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