What Is an Emergency?

Life happens. One minute you’re making dinner and the next you slice your finger. Luckily, your health care coverage puts you in control of your health care and costs.

You have choices when it comes to choosing care. Just because your finger is hurt doesn’t mean you need to go to the emergency room (ER). And in some cases, if you do go to the ER, your visit isn’t covered. This means you could end up paying part or all of the bill.

Knowing what is — and isn’t — an emergency can help you plan for the unexpected.

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When the ER Should be Used

You should go to the ER for life-threatening symptoms, such as:

  • Heart problems
  • Breathing problems
  • Heavy bleeding
  • Broken bones
  • Severe pain
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When the ER Shouldn't be Used

You have choices other than the ER for health concerns like:

  • Colds, sore throat and flu symptoms
  • Ear or sinus pain
  • Rashes
  • Cuts that don’t need stitches 
  • Constipation
  • Tolerable pain

Call our 24/7 Bilingual Nurseline

Bilingual (English and Spanish) nurses are available 24 hours a day, seven days a week. Call 1-800-299-0274 for help identifying some options when you or a family member has a health problem or concern.

Estimate Treatment Costs

Before going for any care, you can log in to Blue Access for MembersSM (BAMSM) and use the cost estimator tool to compare costs.

Freestanding Emergency Room or Urgent Care

Knowing whether to go to freestanding emergency care centers and urgent care centers can be tricky. While they may seem like the same thing, they do have different buildings and visit charges.

Emergency care centers:

  • Will have the word "Emergency" in its name or on the building
  • Charge ER rates, even if the care you need is minor
  • Are mostly out-of-network, so you may get a bill for the amount that your health care plan doesn't cover

Knowing this may help you decide where to get care for health concerns or true emergencies.


Last Updated: Oct. 18, 2023