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Health insurance works differently in emergencies!

Emergency care can vary in price and services depending on where you go. You can save time and money and get the care you need if you know:

  • the differences between emergency room (ER) facilities and urgent care centers, and
  • how to get info about your insurance company’s coverage network.

 

Not all emergency care is the same.

  • Hospital ERs are inside a hospital and treat all kinds of emergencies.
  • Freestanding ERs are not part of a hospital, but can handle most of the same emergencies as a Hospital ER.  
  • Urgent Care Centers can help you with minor injuries and illnesses, like small cuts, infections, or sprains. Urgent Care Centers are not for serious or life-threatening illnesses and injuries.

How much you pay depends on where you go.

  • Insurance companies pay for different parts of your bill based on where you go.
  • If the place you go is not in your company’s network, you may have to pay more.
  • Some companies will not pay if you use an ER outside of your network for non-emergency care.

 

Know where to go.

  • Before you have an emergency, know where to go. You can save yourself money by choosing the right place.
    • If an ER or Urgent Care Center is in your network, you will pay less than if they are not in your network.
  • Your insurance company has a directory. A directory lists which ERs or Urgent Care Centers are part of your network. Most directories are on your company’s website.
  • Some insurance companies offer apps for your phone. These apps help you find ERs and Urgent Care Centers in your area and in your network.
  • “Accepting” insurance is not the same thing as “being in network.” You need to know if the place:
  1. accepts your insurance, and
  2. is in your network.

 

Need help?

  • Have more questions? Call us at 512-322-4143.
  • What if you have health insurance but still get a large bill? You may not have to pay the bill or may only have to pay for some of it. Find out if you qualify for help with your medical bill. Contact the Texas Department of Insurance (TDI) and ask about their mediation program. Call 1-800-252-3439 or go to www.tdi.texas.gov/consumer/cpmbalancebilling.html
  • Do you have a complaint about your health insurance? Call TDI at 1-800-252-3439 or visit  www.tdi.texas.gov/consumer/index.html.