KNOW WHERE TO GO

Your Care Options: Explained

RIGHT CARE – RIGHT PLACE – RIGHT CHOICE

When you or a loved one gets sick or injured, it can be really scary. You may not be sure where you should go—especially at night or on the weekend. Can it wait until your doctor's office opens? Should you head to urgent care? Is it serious enough for the emergency room (ER)?

It's not always easy to make the best decision. But it is important.

Time, cost, hassle—your health care experience can be very different based on where you go. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) wants to help you choose wisely. And the first step is having a clear picture of all your options.

Remember: If you have an issue that threatens your life or health, never wait. Call 911 or go straight to the nearest emergency room!

COMPARE YOUR OPTIONS:

Health Line Blue (1-877-477-2424)

Good choice for:

  • Minor health issues
  • Moderate health issues

You can talk to a nurse anytime—day or night— by calling Health Line BlueSM. They'll help you decide the best place to get care based on your symptoms. They can also help you treat your issue at home or ease your symptoms until you can get in to see your doctor.

Just call 1-877-477-2424 (toll-free). We've included Health Line Blue on your Quick Reference Guide so you'll have their number close by. Add the number to your phone, too. You'll also find the nurse support line listed on the back of your member ID card.

What to expect

You'll connect with a nurse quickly to talk through your options. And best of all, Health Line Blue is free!

Experts on-call for you—24 hours a day, 7 days a week

Health Line Blue is also a great resource for many things beyond just finding care. Make them your first call when you want to:

  • Get quick answers: Find out what your symptoms may mean; learn how to treat injuries or illnesses at home; ask about things you don't understand after a doctor's visit
  • Check treatments: Understand your medications; get support when making decisions on tests or other procedures; learn about other treatment options that may be available
  • Feel your best: Learn more about managing chronic conditions, like high blood pressure, diabetes or asthma; ask questions about your medications; prep for an upcoming doctor's visit

Your Doctor

Good choice for:

  • Preventive care
  • Minor health issues
  • Moderate health issues

Think of your doctor as your medical “home”—or the quarterback of your entire health care team. It's who you should go to for most medical needs, such as preventive care, regular screenings or tests, and illnesses or injuries. It's also the person you talk to about your health questions and concerns.

Don't have a doctor yet? Here are 5 tips for choosing one. Then, use our Find a Doctor tool to research your options.

Finally, fill in your doctor's information on the Quick Reference Guide so it's always handy.

What to expect

On average, people spend 19 minutes2 waiting to see their doctor—then get about 21 minutes3 in face-to-face time. So, the typical doctor's visit takes only 40 minutes in total. That means you'll save a lot of time compared to a trip to the ER. And it's even quicker than most urgent care centers.

The cost of a doctor visit depends on your specific health plan. But it's much less than a visit to the ER, where the average member cost is $667.4 And the copayment or coinsurance for a doctor visit is often less than what you'd pay at an urgent care clinic, too.

All in all, you'll save the most time and money by going to your doctor for any health care need that isn't a true emergency!

A relationship that's important for your health

Some people have seen the same doctor for decades. But even if you're just starting to see a doctor, the relationship is still an important one to build up. Here's why:

  • They get to know you: Your doctor gets to know your health, so they're able to provide you with the best overall care. They also are key to managing any long-term health conditions—or lowering your chance of getting them in the first place.
  • You save time: When you have a health history with a doctor, it saves you time and cuts down on paperwork. Plus, visits are usually much quicker than at the ER or urgent care. And many doctors offer walk-in and same-day appointments—as well as weekend hours and after-hours phone lines.
  • You save money: Seeing your doctor usually means lower copayments or costs compared to other care options. Over time, getting regular care from you doctor helps prevent costly health problems in the future, and can keep you out of the hospital.

Urgent Care Center

If you can't get a same-day appointment with your doctor, urgent care centers are a good back-up option for issues that just can't wait. Their aim is to treat patients quickly and efficiently. Problems like a cut finger, sprained ankle or severe cough are good reasons to visit urgent care.

In North Carolina alone, there are more than 250 dedicated urgent care clinics. Most are open seven days a week and offer extended hours, including weekends and evenings. Some areas even have around-the-clock urgent care options.

Use our tool to find urgent care options near you—then add that information to your Quick Reference Guide.

What to expect

Typically, you'll wait 30 minutes or less to see a nurse practitioner or doctor at an urgent care center—and spend 1 hour or less in total for a visit.5 That's longer than the average visit to your doctor, but still much better than a trip to the ER.

The same is true of costs. The average Blue Cross NC member will pay $59 for an urgent care visit.4 That's more than the copayment or coinsurance you'll pay for a doctor visit under most health plans. Yet it's quite a deal compared to the emergency room, where the average member will pay more than 10 times that amount!4

Convenience care centers or retail clinics

For minor health issues, convenience care centers are another back-up option. These are walk-in clinics with extended hours, where you can get basic care from a nurse practitioner. Some are even housed within retail stores. They can treat common illnesses like sinus infections, colds, flu, allergies, urinary tract infections or sore throats.

As the name implies, these clinics are convenient. Because the health problems are minor, a typical visit takes just 45 minutes.2, 7 And the average Blue Cross NC member cost is only $30.4

NOTE: If you do visit an urgent care or convenience care center, let your doctor know about it. That way, your medical record can be updated and stay accurate.

Emergency Room (ER)

The emergency room is your best option if:

  • You feel your life is in danger: For example, chest pains, seizures, can't breathe or head trauma.
  • You need major care right away: For example, broken bones, major burns or heavy bleeding.

Think of the ER as a last resort for true emergencies that require immediate, specialized care.

What to expect

Since the emergency room is built to deal with life-or-death situations, it's the most expensive and time-consuming care option you have.

In North Carolina, you'll wait nearly 30 minutes on average until you first see a doctor in the ER.6 However, the typical visit ends up being a whopping 2 hours and 33 minutes in total!6 That's because the doctor is first looking to see if your life is in danger. If it's not, the doctor will often get pulled into caring for more critical patients first. And the more emergencies that come through the door—the more hours it'll take before you walk out of the ER.

Cost is also much different at the emergency room. Blue Cross NC members pay an average of $667 for an ER visit.4 That's 11 times more than urgent care— and 22 times more than a retail clinic!

Those dollars add up. So, the more we can choose the right care option—the more we can help lower health care costs for everyone. Plus, we'll be freeing up valuable ER resources to focus on helping those that truly need life-saving care!

Emergency care vs. your doctor's care

Some people think they'll get the best health care at the ER. But the truth is that for issues that aren't life-threatening or very severe, you'll get the best care at your doctor. Here's why:

  • The ER's job is to make sure you survive: They measure success by whether you walk out the door. So their goal is to figure out what you DON'T have by ruling out life-threatening conditions. When you go in for a non-emergency, the ER typically only treats your symptoms—not what's actually causing those symptoms. And that raises the risk that the same problem (or a similar one) will happen again in the future.
  • Your doctor is there to help you over the long haul: As your medical “home,” your doctor supports both your current health and your future wellbeing. They'll not only treat the health problems you have today, but help you prevent them from happening again. And they will be in the best position to do that because they know your health history. Things like daily habits, medicines and family history play a big role in your health. So having a doctor that knows those things means you'll get personalized care that's best for you and your unique needs!

Choosing the Right Option

  If you...
Health Line Blue
(1-877-477-2424)
  • Aren't sure where to go
  • Want to discuss options for at-home symptom relief until you can see your doctor
  • Have health questions
Your Doctor
  • Have an illness, injury, pain or health issue
  • Need a prescription or refill
  • Need help managing a long-term condition like high blood pressure, diabetes or asthma
  • Want to prevent problems (preventive care, like checkups or vaccines)
Urgent Care
  • Can't wait until your doctor is available to treat you
  • Have a sudden injury and need a walk-in appointment
  • Need care after-hours or on weekends and your doctor is closed
Emergency Room
  • Have a medical emergency
  • If you have an issue that threatens your life or health, never wait. Call 911 or go straight to the nearest emergency room!

Average Wait Times and Costs

  Average Wait Time Average Member Cost
Health Line Blue
(1-877-477-2424)
  • 16 seconds1
$0
Your Doctor
  • 19 minutes to see doctor2
  • 21 minutes face-to-face time with doctor3
  • 40 minutes total visit
Varies by plan; often lowest-cost option
Urgent Care
  • 30 minutes to see a doctor5
  • 60 minutes total visit5
$624
Emergency Room
  • 30 minutes to see a doctor6
  • 147 minutes total visit6
$6134

Categories for Medical Attention

MINOR HEALTH ISSUES


  • Sore or strep throat
  • Urinary tract and bladder infections
  • Nasal congestion
  • Cough, colds and flu
  • Earaches and ear infections
  • Minor fevers
  • Allergy symptoms
  • Skin issues (including rashes, ringworm and chicken pox)
  • Pink eye
  • Head lice
  • Insect bites
  • Minor burns, cuts and scrapes
  • Sprains and strains
  • Back or neck pain

MODERATE HEALTH ISSUES


  • Migraines
  • Vomiting and diarrhea
  • Severe cough
  • Fevers
  • Asthma attacks (mild to moderate)
  • Eye irritation
  • Minor reactions to medications (itchiness, skin rashes, hives)
  • Animal bites
  • Wounds requiring stitches

MEDICAL EMERGENCIES


  • Chest pain
  • Severe abdominal pain
  • Severe trouble breathing
  • Suddenly not able to speak, see, walk or move
  • Suddenly weak or drooping on one side of the body
  • Pain in the arm or jaw
  • Coughing or throwing up blood
  • Heavy bleeding
  • Severe burns or deep wounds
  • Head trauma
  • Major broken bones
  • Seizures or convulsions

Next Steps

Now that you have a clear picture of your options, what's next? Here are 5 things you can do today so it's easier to make smart care choices in the future.

1) Select a doctor (if you don't already have one).

If you don't have a doctor yet, first read these 5 tips for choosing one. Then, use our Find a Doctor tool to choose one and schedule an initial health checkup.

2) Add Health Line Blue to your phone's contact list.

Never used Health Line Blue? Often, making that first call helps you feel comfortable using it in the future. So do it today by calling 1-877-477-2424. (Save this number in your phone for easy access.) You can ask any health questions that are on your mind—or simply learn more about the care options we've talked about here. They can also help you with things like preventive care, managing chronic conditions or prepping for a doctor's visit.

3) Use your Quick Reference Guide.

If you haven't already done so—download, print and fill out your Quick Reference Guide. Then, tack it on your fridge or by the phone so it's handy. It provides at-a-glance information on the care options we've talked about. So when a health problem crops up, you'll know what to do!

4) Choose your back-up option by locating an urgent care center close to home.

Check out our Urgent Care Finder tool to find a clinic that's nearby. You'll want to add this information on your Quick Reference Guide.

5) Stay connected.

Blue ConnectSM gives you information to help manage costs, make better care decisions and reach your health goals—anytime and on any device. 

Log in to Blue Connect

 


This is not medical advice. Consult a medical professional and seek assistance in an emergency.

  1. Nurse24 Detail/Nurse Line Performance Report (Alere, Q1-2016).
  2. 6th Annual Vitals Index. Online: www.vitals.com/about/posts/press-center/press-releases/wait-times-doctors-decrease-even-americans-enter-health-care-system (accessed June 2016).
  3. Shaw, Meredith K., et al. "The duration of office visits in the United States, 1993 to 2010." The American Journal of Managed Care 20.10 (2014): 820-826.
  4. Average cost to Blue Cross NC members across Group commercial and Individual (Under 65) business. Based on Blue Cross NC internal data for 12 months ending December 2015. Emergency room costs include both facility and professional charges—and combine copayment, deductible and coinsurance.
  5. “2015 Benchmarking Survey Headlines Summary.” Urgent Care Association of America. Online: www.ucaoa.org/page/IndustryNews (accessed June 2016).
  6. Average times shown are for emergency departments in North Carolina. Source: https://projects.propublica.org/emergency/ (accessed June 2016).
  7. “Convenient Care Clinics: Increasing Access (Fact Sheet).” Convenient Care Association. Online: http://www.ccaclinics.org/images/PDF/CCA_IncreasingAccess_2017.pdf (accessed March 2017)

Blue Cross NC provides the Health Line Blue program for your convenience and is not liable in any way for the goods or services received. Blue Cross NC reserves the right to discontinue or change the program at any time. Decisions regarding your care should be made with the advice of your doctor.