What is the Difference between Urgent Care Clinic and Free-Standing Emergency Rooms?

Health Insurance

Have you noticed? Free standing Emergency Rooms are on every street corner in the Dallas/Fort Worth metroplex. While the facilities seem convenient and advertise “no wait time,” they are rarely in any insurance carrier’s network and the cost does not count toward your in-network medical deductible. Furthermore, since these facilities are not in-network they are able to balance bill patients, which leads to exorbitant out-of-pocket costs. It is recommended that if individuals need care and their Primary Care Physician’s office is closed, to use an Urgent Care Clinic.

Free-Standing Emergency Room

Did You Know?
  • The average cost of care at a freestanding Emergency Room in Texas was $2,199 in 2015, compared with $168 at an Urgent Care.
  • It is estimated that $18 billion could be saved nationwide if patients avoided ERs for non-urgent issues and utilized Urgent Care, Primary Care Physicians or Telemedicine

It is important to know the difference between an URGENT CARE and EMERGENCY ROOM to avoid potentially exorbitant out-of-pocket emergency costs.

When Should You Go to an Urgent Care Clinic?

These conditions may be treated at Urgent Care clinics:

  • Fever
  • Ear Pain
  • Nausea or Vomiting
  • Rashes, cuts, or scrapes
  • Bone X-Rays, sprains, or strain
When Should You Go to an Emergency Room?

These conditions may be treated at an Emergency Room:

  • Heart attack symptoms
  • High fever with stiff neck, mental confusion
  • Wounds that won’t stop bleeding
  • Stroke

Note: If you are experiencing any one of these conditions above, it is recommended that you visit an ER attached to a hospital.

Question: We have a sizable health savings account in my wife’s name. She will turn 65 and go on Medicare in August 2016. I am 71, and my monthly Medicare Part B premium is deducted from my Social Security payment. Can we use money from her HSA to pay our Part B premiums, even though they’re automatically deducted from my Social Security benefits? Can we also pay our Part D prescription-drug premiums from the HSA?

Answer: After your wife turns 65, you can use money from her HSA to pay Medicare premiums for both of you. And even though your premiums are deducted from your Social Security benefits, you can withdraw money from the HSA tax-free to reimburse yourselves for the Part B premiums. You can also use the HSA money to pay Part D premiums for both of you, as well as premiums for Medicare Advantage plans (but not medigap).

Keep in mind that your wife will no longer be able to make new contributions to her HSA after she signs up for Medicare.

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