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The ER or Urgent Care: Making the Decision

2/26/2014

When we’re in pain or sick, we’re anxious and it can be hard to think straight. We want relief as soon as possible. When a child is hurt or ill, the anxiety can be even greater. In those moments, it is can be hard to determine if you need to go to the emergency room, an emergency center, or if an urgent care center will do. It’s important to make that distinction because making the wrong choice will cost both time and money.

Generally, if a condition is threatening to life, limb or eyesight, or causes the beneficiary to require relief from pain, it is considered an emergency and calls for a trip to the emergency room. TRICARE defines an emergency department as an organized, hospital-based facility available 24 hours a day providing emergency services to patients who need immediate medical attention. Emergency departments affiliated with a hospital are most likely TRICARE-authorized providers. Beneficiaries and their families will get the appropriate level of care and save money by having urgent care needs met in urgent care facilities.

Over the last two decades, over 9,000 urgent care centers have emerged across the country and this may lead to more urgent care facilities in an area than emergency rooms. However, beneficiaries who seek care at emergency centers need to ask if it is affiliated with a hospital-based emergency department. If it isn’t, the beneficiary will need to make a decision about getting care elsewhere or being responsible for those facility charges.

Beneficiaries can check if a provider is TRICARE-authorized by calling their regional contractor. Contact information for regional contractors is available at www.tricare.mil/callus.  Learn more about emergency care under TRICARE at www.tricare.mil/emergency.

Last Updated 6/3/2014