Network Health 2024 Medicare Advantage PPO plans are rated 5 out of 5 stars by Medicare. Learn more.

Network Health Blog

Where Should You Go When You Need Medical Care?

signs pointing to different sites of health care

By Laura Reinsch, director of care management at Network Health

Primary Care vs. Urgent Care vs. Emergency Room

If you or a loved one becomes hurt or very ill, panic and confusion can make it difficult to know what to do. This includes making the right decision on where to receive care.

Of course, if you feel you’re experiencing a medical emergency and need immediate assistance, it’s best to call 911. Other times, it isn’t obvious whether you should visit your personal doctor versus urgent care or an emergency room. Even choosing between an urgent care center versus a hospital emergency room may not be such a clear choice.

That said, choosing the right place to go for care is critical to receiving the adequate and timely care you need while also avoiding paying more than is necessary. Let’s compare your options for care between a virtual doctor visit, an in-office visit with your personal doctor, urgent care and the emergency room.

When to Use Virtual Care Instead of Visiting Your Personal Doctor’s Office

If your medical need is not an emergency and you can wait at least 24 hours, then either an in-person or virtual visit with your doctor is likely the best option. Which option you choose is generally up to your individual preference and your medical needs.

Virtual visits with your doctor can be great for consultations to discuss ongoing treatment or prescriptions. For example, if your doctor changed your prescription for an anxiety medication, a virtual visit may be a convenient way to follow up to discuss the new medication’s effectiveness and potential side effects. On the other hand, there are some health care needs that should be handled in person, such as your annual wellness exam. Some forms of health care, like vaccinations, can only be performed in person.

When to Use Urgent Care Instead of the Emergency Room

For more severe medical needs, a visit to urgent care or the emergency room may be considered. Although it isn’t always easy to know when it is appropriate to use one or the other, a good rule is to use urgent care for unexpected injuries or illnesses that are not life threating. The emergency room should be used for illnesses, injuries, symptoms or conditions that require immediate care in order to avoid serious harm to your health, including life-threatening situations.

To better understand which site of care is most appropriate, view the chart below to compare examples of specific health care needs.

Virtual Visit

  • Follow-up visit for medication
    or care management
  • Prescription refills
  • When you’re too sick to leave home 
    but don't require immediate care

Primary Care

  • Annual wellness visits
  • Coughs and colds
  • General concerns, visits and physicals
  • Sore throats
  • Vaccinations

Urgent Care

  • Allergic reactions
  • Cuts requiring stitches
  • Fever
  • Pink eye
  • Sinus infections
  • Vomiting

Emergency Room

  • Chest pain
  • Head or neck injury
  • Sudden numbness in an arm or leg
  • Trouble breathing
  • Uncontrolled breathing
  • Serious burns


Cost Difference Based on Site of Care

Choosing the appropriate location for your health care needs is not only important because it helps ensure provider efficiency but also because it helps you to avoid paying more for health care than needed.

On average, urgent care costs $600 less than going to the emergency room. The emergency room can cost up to seven times more than other care. Generally speaking, both urgent care and the emergency room are going to cost considerably more than a visit with your personal doctor who is in-network with your health insurance plan.

If you have questions about how a Network Health plan covers these various sites of care, give us a call using the number on the back of your member I.D. card or find your preferred form of contact at the link below.

Contact Network Health

Network Health
1570 Midway Place
Menasha, WI 54952
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

COVID-19 Information for Network Health Members

Learn more about the recent Change Healthcare breach.