Emergency Room vs. Urgent Care: Where Do I Go?
Key takeaways:
Urgent care facilities are equipped to provide last-minute care. But they can’t always handle life-threatening conditions because they don’t always have the resources for certain diagnoses or treatment. It helps to think of them as standard medical clinics with extended hours.
Emergency rooms (ERs) can take care of any medical emergency, regardless of your insurance status or ability to pay for services. You should go to an ER if you have new or concerning symptoms, need more involved testing, or require immediate treatment.
Urgent care centers offer less costly care compared with emergency rooms. But urgent care centers operate under different rules, and some may not accept Medicaid.
It’s likely that you have several different options in your local area when you need last-minute or emergent medical care. These typically include urgent cares, freestanding emergency rooms, and large hospital emergency departments. It can be confusing to understand what each facility can handle and when it’s better to go to one place over another. And that’s the last thing you need when trying to deal with a bleeding cut, an upset stomach, or a new episode of chest pain. So let’s run through these options to help you make the best decision.
Quiz: Should I go to urgent care or the ER?
xWhat’s the difference between the emergency room and urgent care?
Urgent cares can have many different names: after-hours clinics, walk-in clinics, minute clinics, and minor emergency centers. The most accurate way to think about them is as standard medical clinics or offices, rather than emergency care centers.
But unlike standard medical offices, they often have the added benefit of extended hours and walk-in appointments. Plus the staff may have more experience with emergent conditions than your average provider’s office.
Urgent care centers
Urgent care facilities generally have these characteristics:
Appointments: Most don’t take appointments, but instead see patients on a walk-in basis. Some centers do allow people to make same-day appointments or add themselves to a wait list, but often these aren’t set in stone.
Hours: Most are open 365 days per year, with extended hours that include evenings and weekends.
Staffing: This can vary, but staff often includes a physician and advanced practice provider (such as a nurse practitioner or physician assistant). These providers may have varying specialties, most often emergency medicine or internal medicine (primary care).
Labs: Most have limited lab capabilities that can handle simple tests like checking a blood sugar or analyzing a urine sample. Some may be able to do basic lab work like a blood count or electrolyte panel.
Radiology: Most have X-rays, but they usually don’t have more advanced imaging like CT scan or MRI.
Medications: They may be able to place intravenous (IV) lines to administer fluids or medications, but that’s not always the case. This also means they may be limited in their ability to give other IV medications, like pain relievers or antibiotics.
Age range: Most can see people of all ages, but some may not offer care for infants or young children. But there are also pediatric urgent care centers that only care for infants and children.
Payment: They often require payment at the time of service.
It’s important to understand that there’s no regulating body for urgent care facilities. This is why there’s a lot of variability in what care they can provide. This also means they aren’t required to treat people who can’t afford their services.
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Emergency rooms
In contrast to urgent care facilities, emergency rooms (ERs) must adhere to the Emergency Medical Treatment and Labor Act of 1986 (EMTALA). This means that they are required to treat anyone who comes to the facility, regardless of insurance status or ability to pay.
ERs are equipped to take care of any medical emergency. Most of them are attached to a larger hospital that can also provide an even larger range of medical services.
ERs have the following characteristics:
Appointments: They don’t take appointments. Patients go through a triage process when they arrive, which is how the staff determines who needs attention first.
Hours: They’re open 24 hours a day, 365 days a year.
Staffing: There must be at least one physician in the ER or hospital at all times. Most of these physicians are trained and board-certified in emergency medicine. Most ERs have multiple doctors present at one time, as well as advanced practice providers with experience in treating emergent conditions.
Labs: They can do a wide range of blood and urine tests.
Radiology: They offer all imaging modalities, including X-ray, ultrasound, CT, and MRI.
Medications: ER and hospital pharmacies are fully equipped with all necessary medications for emergent situations. This includes medications to adjust heart rate and blood pressure, medications to help with breathing, pain medications, antibiotics, IV fluids, and blood products. And the list goes on.
Age range: ERs treat patients of all ages. While there are specific ERs for children, all board-certified emergency medicine physicians have training in the treatment of both adult and child emergencies.
Payment: They don’t require payment at the time of service.
Freestanding emergency rooms
Freestanding emergency rooms are becoming more common as hospital systems try to respond to the increased demand for urgent and emergent care. These are ERs that aren’t physically attached to a larger hospital.
Freestanding ERs are required to operate like a traditional ER, so they’re equipped to administer emergency treatment. But if you need more involved care — like surgery or admission to the hospital — you’ll need to be transferred from the ER to a hospital. Freestanding ERs usually have an affiliation with a nearby hospital to facilitate this process.
When should you go to an urgent care instead of an ER?
Urgent care facilities are equipped to provide last-minute care, but they can’t always handle life-threatening conditions (even though there are certain lifesaving medications they keep on hand, like epinephrine for an anaphylactic reaction).
If you can’t get an appointment with your regular provider, or if their office is closed, an urgent care center might be the right place. Conditions that urgent care centers commonly treat include:
Upper respiratory infections (like the common cold)
Ear aches
Strains or sprains
Smaller cuts that may need stitches (ERs can better address extensive or deep wounds due to their larger supplies)
Mild burns
Rashes
Because urgent care centers generally take care of simple conditions, they can usually see patients at a faster pace. So if you’re sure you have a minor or easily treated condition, you’ll likely be able to get quicker treatment at an urgent care center.
When should you go to an ER instead of an urgent care?
If you have any concern that your condition is a potentially serious or life-threatening emergency, you should go directly to an ER. If you can’t get to an ER quickly, it’s best to call 911.
An ER is the best place to get an evaluation if you have any of the following symptoms or conditions:
Chest pain, or any symptoms that you think could be related to your heart
Loss of consciousness or confusion
Seizures
Poisoning
Severe allergic reactions
Difficulty breathing
Vomiting or coughing blood
Vaginal bleeding or abdominal pain in pregnancy
Head trauma
Injuries from motor vehicle collisions
Broken bones
Any condition that you think may need surgery or a stay in the hospital
If you’re pretty sure you don’t need medical care right away, you can also:
Call your regular provider’s office. They often have an on-call triage nurse who can help direct you to the right place.
Call your local urgent care to ask about specific services, like if you can get a test for strep throat.
A call to the ER probably won’t be as helpful. That’s because the staff member answering the phone won’t be able to provide medical advice over the phone.
At the end of the day, if you aren’t sure where to get an evaluation — it’s always better to be safe and opt for an emergency room.
Cost: Urgent care vs. emergency room
Urgent care centers are almost always cheaper than going to the emergency room — as much as 10 times cheaper, by some estimates.
Urgent care centers get about two-thirds of their business from people with private insurance. Many also accept Medicare and workers’ compensation insurance. But unlike ERs, they may choose not to accept Medicaid. To save money, you may want to:
Go to your health plan’s website to find a list of urgent care centers in your insurer’s network. Or call ahead to make sure the urgent care center accepts your health plan.
Be aware that your copay or coinsurance at an urgent care center may be higher than a visit to your primary care physician. But it’s still likely lower than a visit to an ER.
If you have health insurance, you can get an estimate of the cost of your visit. Urgent care centers “are able to provide an estimate of costs as long as they can access the patient's insurance information and coverage at the time of the request,” according to Lou Ellen Horwitz, chief executive officer of the Urgent Care Association, in an email to GoodRx Health.
What’s the out-of-pocket cost at an urgent care center compared to an ER?
If you have private insurance, you may pay an ER visit copay of $50 to several hundred dollars, depending on your health plan. Some plans waive the ER copay if you’re admitted to the hospital. Check with your health plan for details.
The total out-of-pocket cost for the ER visit is almost certainly going to be higher than the ER copay. This is to account for tests you need and specialists who see you. And depending on your plan’s deductible — and if you’ve already satisfied your deductible for the year — you may have to pay a big bill.
No one wants to hear that they might see a large bill. But there’s good news. Emergency care costs should be more predictable and less shocking with new consumer protections in the No Surprises Act, which bans most surprise out-of-network and balance billing. Starting in 2022, ER claims are required to be covered at in-network rates, and people have new ways to seek help if they get stuck with what they believe is a surprise bill.
The bottom line
There’s a lot of overlap in the care that emergency rooms and urgent care centers provide. Urgent care centers can vary in the services they’re able to provide. Regardless of which facility you choose for your medical needs, the provider you see will ultimately make sure you end up in the right place. But in true medical emergencies, minutes can be precious and make a big difference in your care. So when in doubt, it’s best to err on the side of caution and head straight to the emergency room.
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References
Allen, L. et al. (2019). NBER working paper series: Urgent care centers and the demand for non-emergent emergency department visits. National Bureau of Economic Research.
American Stroke Association. (n.d.). Stroke symptoms.
Pollitz, K. (2021). No Surprises Act implementation: What to expect in 2022. Kaiser Family Foundation.
UnitedHealth Group. (2019). The high cost of avoidable hospital emergency department visits.
Urgent Care Association. (2019). Urgent care industry white paper.
