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Where to get care: Get help without paying more than you need to

A new freestanding emergency room (ER) just popped up around the corner. There’s a walk-in retail clinic and an Urgent Care Center right by your supermarket. Two different hospitals are also nearby. It can be hard to know where to go when you have a stomachache, a fever, or even an emergency like heart palpitations with all these options.

It’s important to know where to go so you get the right kind of in-network care and the highest level of benefits, so you don’t spend more than you have to. You can download this flier to keep handy when deciding where to go. 

Here’s information about some of the places you can get care covered by your TRS-ActiveCare plan.

Your Doctor's Office

Need a checkup, routine health exam, regular screening, or follow-up? Make an appointment with your doctor. You can also head to your doctor’s office for fever, colds, flu, sore throat, stomach aches, and other types of non-emergency medical care.

Here’s the benefit of seeing your regular doctor whenever possible: Your doctor and any specialists you see regularly know your health history, the medications you take, and your lifestyle. They can decide if you need tests or additional care and help you monitor chronic health issues like asthma or diabetes. 

Retail Clinics

Can’t get an appointment right away with your doctor? Walk-in retail clinics are a low-cost option for minor health issues like infections, minor injuries or pain, and strep throat. Many of these clinics offer extended hours, so you may be able to be seen on weekends or at night.

Urgent Care Centers

Need immediate attention like an X-ray or stitches but don’t have life-threatening symptoms? Urgent Care Centers are convenient and more affordable than ERs for conditions like cuts that need stitches, migraines or headaches, back pain, sprains or strains, animal bites, rashes or tolerable pain. Some Urgent Care Centers even offer online check-in so you can get in line ahead of time and avoid sitting in the waiting room.

Hospital ERs

For life-threatening symptoms, call 911 or go right to the hospital ER. Examples include heart problems or heart attack, chest pain, stroke, breathing problems, heavy bleeding, broken bones, and sudden or severe pain.

You have three additional options for care with your TRS-ActiveCare plan that are convenient and affordable: telemedicine, TRS Virtual Health, and the 24/7 Nurseline.

Telemedicine

With your health benefits, you can get care without even leaving home or work in three ways:

Telemedicine—You can use telemedicine for non-emergency medical and behavioral health visits with your current providers. Check with your doctor and specialists to see if they offer care online or over the phone. Check your Summary of Benefits and Coverage for more details.

TRS Virtual Health—Your BCBSTX coverage also includes TRS Virtual Health powered by Teladoc® and RediMD™. You can make an appointment with a board-certified doctor or therapist anytime, day or night, and be seen online or over the phone. Download this helpful flier for more information.

24/7 Nurseline—Staffed by registered nurses, the 24/7 Nurseline is a great tool you can use to figure out if you need to go to the ER or to your doctor. Call anytime, day or night, and speak to a health professional who’ll advise you on the right level of care for your symptoms. Data shows 75% of 24/7 Nurseline callers were guided to a more appropriate level of care and 95% of those callers were able to avoid the ER or other more expensive types of care, saving them money. 

Avoid Freestanding ERs

Freestanding ERs have been popping up all over Texas, so there might be one right down the street. But that doesn’t make it the right choice when you need help. While freestanding ERs look like Urgent Care Centers, the cost here can be shocking.

Freestanding ERs are typically out-of-network, so you’ll be responsible for paying the entire cost of your care. How much are we talking about? Take a look at a couple of eye-opening statistics from a previous plan year:

  • On average, a participant with a throat condition paid $2,800 for a visit at a freestanding ER; the same care would’ve cost them $97 at an Urgent Care Center.
  • Participants with headaches or migraines paid $5,500 at a freestanding ER instead of $92 at an Urgent Care Center.

Freestanding ERs are also not typically equipped for trauma, which means you’ll have to be transported to a hospital if they can’t treat you. Not only could that be dangerous if it delays your care, but you’ll also have to pay for care at multiple facilities, not to mention the ambulance ride.

Here’s how to spot a Freestanding ER:

  1. Freestanding ERs look like Urgent Care Centers but include “EMERGENCY” in the name.
  2. Freestanding ERs are usually open 24 hours a day, seven days a week. Urgent Care Centers typically close at night.
  3. Freestanding ERs are not connected to a hospital.

Remember, you can always call a Personal Health Guide for help. You also have access to the 24/7 Nurseline at 1-833-968-1770 to answer health-related questions and help to decide whether to go to the ER or see your doctor.

For more cost saving measures, visit Cost-saving tools.