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When To Get Emergency Care vs. Urgent Care

SEPTEMBER 25, 2024 – Do you know the difference between emergency and urgent care? It can make a difference in your health. Both emergency rooms and urgent care clinics can help you with a medical issue. But they’re different and serve your needs in different ways. When you or a family member needs medical care quickly, it’s important to know the difference between the two.

“In times of stress or concern—like having a sick or injured family member—it can be difficult to know what the right course of care might be,” said Jeannine Pickrell, RN, nurse director of Population Health, TRICARE Health Plan, at the Defense Health Agency. “Making the right choice will ensure you and your family receive the right level of care when you need it.”

When to get emergency care
Emergency care means care for an illness or injury that threatens your life, limb, sight, or safety. If you reasonably believe you have an emergency, always call 911 or your international emergency number. Or, go to the nearest emergency room.

When to get urgent care
Urgent care is for medical issues that aren’t emergencies, but still need attention within 24 hours—for example, a high fever or a sprained ankle. Urgent care providers help with issues that can’t wait for a regular appointment but aren’t so bad that you need to go to the emergency room. Urgent care clinics are often open late and can help with health problems that need care but aren’t life-threatening.

Getting answers
If you’re still unsure about which type of care you need, call the Military Health System Nurse Advice Line. Nurses are available day and night to answer your questions and give you advice on where to go. Call 800-TRICARE if you’re in the United States, Guam, or Puerto Rico. If you’re overseas, visit MHSNurseAdviceLine.com to find your country-specific number.

Making the right choice—especially when you must act quickly—will help you get the care you need.

Knowing what TRICARE covers
TRICARE covers emergency care from any provider, and urgent care from TRICARE-authorized clinics at specific rates based on their group. Learn more about how to get care and what’s covered.

You have options that include telemedicine, telemental health, and urgent care from network providers. Check with your regional contractor to find network providers who offer telemedicine services.

TRICARE will also pay for urgent care from non-network providers, but you might be responsible for out-of-pocket costs. For more information about emergency and urgent care costs, check out the TRICARE Costs and Fees Fact Sheet. (Note: A provider must be TRICARE-authorized for TRICARE to pay any part of your claim, as described in the TRICARE Choices in the United States Handbook.)

Making the best choice
When you must act quickly, knowing the difference between emergency and urgent care will help you make the best decision for your and your family’s health. And making the right choice may lower your costs, too.

Remember, emergency rooms are for serious problems that threaten your life, limb, sight, or safety. Urgent care clinics help with less serious problems that still need immediate attention. The MHS Nurse Advice Line is always available to help you decide where to go. Unlock your health by getting the right care when you need it.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.

Courtesy Story
Defense Health Agency

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