Where Do I Go When I Need Care?
Understanding provider networks
You have options when it comes to where you go for medical care. The type of health plan you choose — such as HMO, PPO, or POS — determines the network of doctors and hospitals you can visit. Look on your health insurer’s website for a provider directory or search tool that lets you find doctors and hospitals within your plan’s network, also known as in-network providers. If a doctor or hospital is not part of your plan’s network, they are called out-of-network providers. Members typically pay more for services from out-of-network providers, and some plans may not cover services from out-of-network providers at all (e.g., HMO plans).
Where to go when your doctor's not available
Many health plans offer you several options for getting in-network medical care, but it’s important to check your plan’s benefits to make the most informed decision about your care.
For most health care needs, you should make an appointment to see your primary care physician. Your primary care physician has the most complete picture of your medical history and can best assess your condition. If your primary care physician is unavailable and you need medical attention sooner, you may have two different options for getting in-network care — retail clinics for minor issues like colds or rashes and urgent care centers for more serious problems, including strains and sprains. But remember, in the case of a life-threatening illness or injury, you should immediately go to the nearest emergency room for treatment.
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Urgent care centers can save you time and money
You don't need an appointment, there's a shorter wait time, and the cost-sharing is generally less than you would pay at an ER.