Page 22 - 2021 Team Member Benefit Guide - English

Where to Go for Care

Confused About Where to Go for Care?
SmartER Care options may save you money.
SM
If you aren’t having an emergency, deciding where to go for medical care may save you time and money.
You have choices for where you get non-emergency care. Use the chart below to help you figure out when Freestanding ER
to use each type of care.
• Open 24 hours, seven
When you use in-network providers for your family’s health care, you usually pay less for care. Search days a week
for in-network providers in your area at bcbstx.com or by calling the Customer Service number on your Hospital ER
member ID card. • Open 24 hours, seven • Could be transferred
to a hospital-based ER
days a week depending on medical
• Average wait time is situation
four hours, seven • Services do not
Urgent Care minutes 4 include trauma care
Center • If you receive care • Often freestanding ERs
Virtual Visits Doctor’s Office Retail Health • Generally open evenings, from an out-of-network are out-of-network. If
provider, you may have
you receive care from an
weekends and holidays
• Available 24 hours a day, seven days • Office hours vary Clinic to pay more. Providers out-of-network provider,
outside the network
a week • Generally the best place to • Based upon retail • Often used when your may “balance bill” you, you may have to pay
• Access to care for non-emergency go for non-emergency care store hours doctor’s office is closed, which means they may more. Providers outside
the network may “balance
and you don’t consider it
medical issues or speak with a licensed an emergency charge you more than bill” you, which means
counselor, therapist or psychiatrist • Doctor-to-patient • Usually lower out-of-pocket your health plan’s fee they may charge you more
whether you’re at home or traveling relationship established cost than urgent care • Average wait time is schedule. than your health plan’s fee
3
• Visit with a health care professional and therefore able to • Often located in stores 16-24 minutes • Multiple bills schedule.
treat, based on knowledge
by calling 888-680-8646, going to of medical history and pharmacies to provide • Many have online for services such as • All freestanding ERs
MDLIVE.com/bcbstx or using the convenient, low-cost and/or telephone doctors and facility charge a facility fee that
MDLIVE mobile app 1 • Average wait time is treatment for minor check-in urgent care centers do
®
medical problems
2
• Medical: Average wait time is less 18 minutes not. You may receive
than 20 minutes. other bills for each doctor
• Behavioral Health: Can be scheduled you see. 5
24 hours a day, but consultations are
conducted by appointment.
$ $ $ $ $ $ $ $ $ $ $ $

If you need emergency care, call 911 or seek help from any doctor or hospital immediately.

1 Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Note: The relative costs described here are for independently contracted network providers. Your costs for out-of-network providers may be significantly
Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. higher. Wait times described are just estimates.
Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe.
2 Vitals Annual Wait Time Report, 2017. Virtual visits, Powered by MDLIVE may not be available on all plans. Virtual visits are subject to the terms and conditions of your benefit plan, including
benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance
3 Wait Time Trends in Urgent Care and Their Impact on Patient Satisfaction, 2017. product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-
controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians
4 Emergency Department Pulse Report 2010 Patient Perspectives on American Health Care. Press Ganey Associates. reserve the right to deny care for potential misuse of services.
5 The Texas Association of Health Plans.
The information provided in this guide is not intended as medical advice, nor meant to be a substitute for the individual medical judgment of a doctor or
other health care professional. Please check with your doctor for individualized advice on the information provided. Coverage may vary depending on your
specific benefit plan and use of network providers. For questions, please call the number on the back of your member ID card.

21 Monique Adenaike, HR Assistant James Varnedore, Driver
21
Dallas, TX Roanoke Rapids, NC