Save the ER for Emergencies Only

Author: Anthem Blue Cross and Blue Shield in Maine
Published: 2010/07/16 - Updated: 2025/02/16
Publication Type: Informative
Category Topic: Rehabilitation and Hospitals - Academic Publications

Page Content: Synopsis - Introduction - Main

Synopsis: This article provides guidance on when to seek emergency medical care, which is particularly useful for individuals with disabilities, seniors, and anyone concerned about their health. It explains that emergencies are determined by symptoms rather than final diagnoses, emphasizing the importance of recognizing signs like changes in vision, difficulty speaking, or severe pain that necessitate immediate medical attention. The piece also differentiates between emergency departments, urgent care centers, and primary care, offering clarity on where to seek treatment for various health issues. By detailing the risks of delaying care, it encourages proactive health management, which can be crucial for those with chronic conditions or disabilities - Disabled World (DW).

Introduction

For many, summer time means cook-outs, family hikes, and trips to the beach. However, while the good weather brings an increase in outdoor activities, for some it can also mean a trip to the local emergency room (ER).

Main Content

In times past, that visit could mean a long and sometimes expensive wait. But now, thanks to Anthem Blue Cross and Blue Shield in Maine, those needing non-emergent care can now turn to a growing network of walk-in centers across the state.

"Maine is fortunate to have an excellent network of hospital emergency departments which provide a broad range of critical care services to those in need," says Jeffrey Holmstrom, D.O., medical director, Anthem Blue Cross and Blue Shield in Maine. "But if you have a less serious issue, like a sprained ankle, insect bite, or severe sun burn, a walk-in center may be a far better option and save you time as well as money."

Last summer, Anthem introduced a walk-in center benefit to its members, enabling them to utilize a walk-in center when they needed care for non life-threatening issues. The network now includes 19 centers across Maine. In addition to shorter wait times, members also may see lower out-of-pocket costs by utilizing a walk-in center.

"Depending on one's coverage, a standard benefit ER co-pay could be $100 or even higher," said Colin McHugh, vice president, provider engagement and contracting, Anthem Blue Cross and Blue Shield in Maine. "On the other hand, the co-pay at one of these Centers, for the same non-emergent treatment, could be as low as $20."

Dr. Holmstrom, who in addition to serving as Anthem's medical director, maintains an active primary care practice. He said that in addition to lower costs, wait times at a walk-in center are often far shorter than that of an ED for non-critical care.

"When possible, we recommend that our members visit their primary care physicians for non-emergency treatment," he noted. "But if that's not an option, it just makes more economic sense to seek out an urgent care clinic or walk-in center where they are available."

Generally, walk-in centers may be used for the following:

• Minor allergic reactions
• Mild asthma
• Coughs, sore throat
• Bumps, minor cuts, scrapes
• Rashes, minor burns
• Sprains, strains
• Minor fevers, colds
• Minor headaches
• Ear or sinus pain
• Burning with urination
• Eye swelling, irritation, redness or pain
• Back pain
• Nausea, vomiting, diarrhea
• Minor animal bites
• Vaccinations
• X-rays
• Stitches

Emergency rooms should be used for those with the following conditions:

• Any life-threatening or disabling condition
• Sudden or unexplained loss of consciousness
• Chest pain; numbness in the face, arm or leg; difficulty speaking
• Severe shortness of breath
• High fever with stiff neck, mental confusion or difficulty breathing
• Coughing or a wound that won't stop bleeding
• Major injuries
• Possible broken bones

Should I Go to Doctor, Walk-in Clinic, Urgent Care Center, or Hospital Emergency Department: Provides information regarding where to go to get medical care when you are not sure if you should go to a walk-in clinic, urgent care center, family doctor, or hospital emergency department.

As benefits and co-pays may vary based on one's plan, Anthem members should check with their employer for details or call the phone number listed on their back of their identification cards with any questions. Anthem members can also contact the company's 24/7 nurse line to discuss their symptoms with a registered nurse.

"This benefit is part of our ongoing mission to provide our members with quality, cost-effective care in the most appropriate setting," said Mr. McHugh. "We strongly feel that this new program helps support that mission and are excited to collaborate with local providers in this initiative."

Anthem Blue Cross and Blue Shield in Maine

Anthem Blue Cross and Blue Shield in Maine is the trade name of Anthem Health Plans of Maine, Inc., an independent licensee of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Anthem Blue Cross and Blue Shield in Maine and published on 2010/07/16, this content may have been edited for style, clarity, or brevity.