Using SmartER CareSM Options

If you aren’t having an emergency, knowing where to go for medical care may save you on cost and time.

You have choices for where you get non-emergency care — what we call SmartER Care options. Use these places instead of the emergency room (ER). Plus, when you visit in-network providers, you may pay less for care.

Having an emergency?

 Please call
911

Watch these SmartER Care videos to test your knowledge on your care options.

Video Transcript

Video Transcript

SmartER Care Intro

CHET: Welcome to SmartER Care-- A Game Show Challenge. Our contestants tell us where they would go for care, and we tell them if we agree with their choice. Just a reminder, when your injury or illness is serious or life threatening, call 911 or go to the nearest emergency room immediately. For all your other health care needs, it's a good idea to start with your primary-care provider when available. Are you ready to play SmartER Care?

[APPLAUSE]

SPEAKER: Yes!

CHET: All right, look to the screen for your first question.

SmartER Care Round 1

SPEAKER 1: Oh, no. It's Saturday, and Laura strained her back. What level of care does Laura need?

[BELL]

Jen?

JEN: She should call her primary care doctor. If not available, then maybe an urgent care center in her plan's network. Most of the urgent care centers I know of have weekend hours too.

SPEAKER 1: That's correct, Jen. Even if her primary care doctor isn't in, a doctor at an urgent care center can take care of a muscle strain. No need for the time and expense of an emergency room visit. Answer this question correctly to score. Your toddler tells you that his ear feels sore, and you think it could be an ear infection. He doesn't have a fever or any other symptoms. What level of care does your little one need?

[BELL]

Molly?

MOLLY: The emergency room.

[BUZZER]

SPEAKER 1: Sorry, Molly. The answer we're looking for is "a visit to the child's pediatrician". If not available, you could go to a retail clinic like you can find inside some pharmacy stores or schedule a virtual visit through secure video, or mobile app, or by phone if offered by your health plan.

MOLLY: Well, how do you figure? Ear infections really hurt.

SPEAKER 1: They do, Molly. But when your primary care doctor isn't available, ear infections can be treated at a retail clinic or through a virtual visit with a shorter wait and less of a bite out of your wallet than a trip to the emergency room.

Ouch! That looked like it hurt. Larry broke his leg. What level of care does he need?

[BELL]

Molly?

MOLLY: Well, the answer is obviously his primary care doctor.

SPEAKER 1: Incorrect. James-- chance to steal.

JAMES: Larry needs to go straight to the emergency room. You need to get it taken care of so you don't end up with even worse damage to your leg.

SPEAKER 1: That was the right call to make James. The questions are getting harder, so contestants get ready.

[APPLAUSE]

SmartER Care Round 2

SPEAKER 1: This is Christy, and her head hurts after a long day at work. Her coworker has strep throat, and Christy's worried she might have it too. What level of care does she need? Molly?

MOLLY: She should go to the emergency room, right?

SPEAKER 1: Wrong. Jen?

JEN: Actually, a simple headache isn't life threatening. If her own doctor's office is closed, she could call the 24/7 nurse line and ask about her options or visit a retail clinic if one is open. If her plan offers virtual visits, that's another option available 24/7.

SPEAKER 1: That's correct, Jen. This is the last question before the final round. It's a holiday, and little Charlie is struggling to breathe. He also has a history of severe asthma, and his usual treatments aren't working. What level of care does Charlie need? Molly?

MOLLY: His pediatrician should be able to fix that right up.

SPEAKER 1: Struggling to breathe sounds like it can't wait, Molly. Jen?

JEN: That's right. Struggling to breathe for someone with asthma can be life threatening, especially if treatment isn't working. I'd take Charlie to the emergency room.

SPEAKER 1: That is correct! Congratulations, Jen. You've made it to the final round. Molly and James-- thank you for playing. Stay tuned for the final round after this.

[MUSIC PLAYING]

SmartER Care Round 3

CHET: It's time for our final round. Now Jen, this question is designed to trick you, so be ready.

Tommy punctured his foot on a plastic toy. Dad got the bleeding to stop, but the cut is deep and needs to be cleaned. What level of care do you need?

JEN: After careful consideration Chet, I would need to visit an in-network urgent-care center if my primary-care doctor isn't around. Plus, the wait time is shorter and the copayment is less than for the emergency room.

CHET: That's correct Jen. You're tonight's big winner!

[MUSIC PLAYING]

Congratulations.

Remember, when your injury or illness is serious or life threatening, call 911 or go to the nearest emergency room. Are you still confused where to go? Smart health-care choices can save you time and money.

Goodnight everybody, and don't forget to tune in next week to SmartER Care-- A Game Show Challenge.

Compare Care Options

Select each option to help you decide where to go based on your health care needs.

24/7 Bilingual Nurseline

Bilingual (English and Spanish) registered nurses on call to answer your questions or concerns 1

24 hours a day, 7 days a week

Call 24/7 Bilingual Nurseline at 1-800-581-0353
 

Average Wait Time

29 seconds

Average Costs

Very Low
 

Virtual Visits

You may be able to have a live doctor visit by phone, online video or mobile app
for non-emergency medical and behavioral health care 2-3

24 hours a day, 7 days a week

Log in to Find a Virtual Visit Doctor

Average Wait Time

20 minutes4

Average Costs

Low

Examples

Allergies
Cold/Flu
Depression

Doctor's Office

Talk to the person who knows you and your medical history

Office hours may vary

Log in to Find a Doctor

Average Wait Time

18 minutes4

Average Costs

Low

Examples

Fever, colds and flu
Sore throat
Stomach ache

Retail Clinic

For non-emergency care when you can't see your doctor 5

Hours based on retail store hours

Log in to Find a Retail Clinic

Average Wait Time

15 minutes

Average Costs

Low

Examples

Infections
Minor injuries or pain
Sore and strep throat

Urgent Care

Not an emergency but needs immediate attention

Generally includes evening, weekend and holiday hours

Log in to Find an Urgent Care Center

Average Wait Time

16-24 minutes6

Average Costs

High

Examples

Cuts that need stitches
Migraines or headaches
Back pain
Sprains or strains
Animal bites or rashes
Tolerable pain

Emergency Room

For life-threatening symptoms

Open 24 hours, 7 days a week

Log in to Find the Closest ER

Average Wait Time

4 hours,
7 min7

Average Costs

Very High

Examples

Heart problems, heart attack
Chest pain, stroke
Breathing problems
Heavy bleeding
Broken bones
Sudden or severe pain

Helpful SmartER Care Tips

 

Consider a Virtual Visit Instead of the ER

You may be able to visit with an independently contracted, board-certified MDLIVE doctor or therapist anytime, anywhere by phone, video or mobile app.2-3
Learn more about Virtual Visits.

 

Estimate Treatment Costs

Before going for care, log in to Blue Access for MembersSM to see if you can compare costs.

 

Think About an Urgent Care Center Instead of the ER

Going to an Urgent Care Center instead of the ER for non-emergency care often means shorter wait times and lower bills. Sometimes a visit to the ER for non-emergency care isn't covered.

 

Know How to Tell Urgent Care Centers and Freestanding ERs Apart

Freestanding ERs:

  • Have the word “Emergency” in their name or on the building
  • Are not attached to and may not be affiliated with a hospital
  • Bill separately for the ER and the doctor, even if the care you need is minor

Knowing this now may help you save on future non-emergency care costs. Find urgent care centers8 near you by texting9 URGENTTX to 33633 and then entering your ZIP code.

1 -

The 24/7 Bilingual Nurseline may not be available with all plans. Check your benefits booklet for details.

Back to content - Footnote 1 reference

2 -

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. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral Health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.

3 -

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 product nor 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 reserve the right to deny care for potential misuse of services.

MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.

Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

Back to content - Footnote 2 and 3 reference

4 -

Vitals Annual Wait Time Report, 2017.

Back to content - Footnote 4 reference

5 -

Visiting a Retail Clinic may not be covered with all plans. Check your benefits booklet for details.

Back to content - Footnote 5 reference

6 -

Wait Time Trends in Urgent Care and Their Impact on Patient Satisfaction, 2017.

Back to content - Footnote 6 reference

7 -

Emergency Department Pulse Report 2010 Patient Perspectives on American Health Care. Press Ganey Associates.

Back to content - Footnote 7 reference

8 -

The closest urgent care center may not be in your network. Be sure to check Provider Finder to make sure the center you go to is in-network.

Back to content - Footnote 8 reference

9 -

Message and data rates may apply. Read text messaging terms, conditions and privacy policy.

Back to content - Footnote 9 reference

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