Telehealth, Doctor’s Office, Urgent Care or Emergency Room? Where to Get Care.

When it comes to care, you have options. That is one of the perks of having health insurance. The tricky part is knowing where to go when you are sick, hurt, or staring at a cut that looks worse every time you peek at it.

A Quick Guide to Getting Care

Knowing where to go, and when, can save you time, money, and stress. It also helps you get the right care, at the right time, in the right place. Think of this as your health care cheat sheet:

• Telehealth (virtual care) for quick, convenient help with non-emergencies.

• Doctor’s office (primary care) for ongoing and preventive care.

• Urgent care (non-emergency) or same-day for non-life-threatening issues.

• Emergency rooms (ER) for serious or life-threatening emergencies.

Have a Plan

If you can, start by contacting your primary care doctor. They know you and your family’s health history and can point you to the right place for care.

When someone in your family is sick or hurt, knowing where to go for care is just as important as knowing what type of care you need. This is why it helps to have a plan of action before you need care.

Work with your primary care doctor to identify your best options for telehealth, office visits, urgent care, and the ER. Once you have a simple plan, you already know what to do for after-hours or same-day care instead of having to decide in a panic.

Always call 911 or go to the ER if you or a family member has serious symptoms such as chest pain, difficulty breathing, loss of consciousness, deep wounds, broken bones, or a very high fever.

Where to Get Care

This guide walks you through four common options for getting care.

Telehealth

Telehealth is pajama-friendly care from your couch. It lets you connect with a doctor or other provider by phone, video, or app. It often has the most flexible scheduling, especially outside regular office hours, and offers a wider range of availability. Many visits can even be same-day.

Telehealth is a great option for:

• Cold and flu symptoms

• Mild respiratory infections

• Ear infections

• Urinary tract infections (UTIs)

• Allergies

• Common skin conditions like acne or eczema

• Medication management

• Mental health services (therapy, counseling, follow-up visits)

Doctor’s Office

Your primary care provider is your home base for health care. They are your best option when you need care soon, but it is not an emergency. They handle most health concerns, follow-ups, and preventive care, and they already know your history and medications. Check with your provider for availability.

Your doctor’s office is a great option for:

• Earaches

• Sore throat

• Fever that responds to medication

• Cold and flu symptoms

• Chronic cough

• Sinus infections

• Repeated or mild urinary tract infections

• Pink eye

• Minor cuts and burns

• Follow-up visits

• Ongoing condition management

Urgent Care

Urgent care fills the gap between your doctor’s office and the ER. It is for when you need help today, but it is not a movie-style emergency. This is a great option any time your regular doctor is not available.

Urgent care is a great option for:

• Wheezing or shortness of breath that is not severe

• Sprains and strains

• Less severe burns

• Small cuts

• Fever without a rash

• Rash without a fever

• Painful urination

• Cold, flu, and congestion symptoms

• Sore throat

• Ear pain

• Nausea, vomiting, or diarrhea

• Abdominal pain that isn’t severe

• Animal or insect bites

Emergency Room

The emergency room is for severe, sudden, or life-threatening conditions. ERs are open 24 hours a day. If you think you are having a medical emergency, call 911 or go to the nearest emergency room right away. When in doubt, treat it as an emergency.

The ER is a crucial option for:

• Chest pain or difficulty breathing

• Weakness or numbness on one side of the body

• Fainting, confusion, or sudden change in mental status

• Uncontrolled or heavy bleeding

• Suspected poisoning

• Broken bones or dislocated joints

• Serious burns

• Signs of shock

• Slurred speech

• Deep cuts that may need stitches

• Head or eye injuries, or cuts on the face

• Fever over 100 degrees F in a newborn

• Fever over 103 degrees F

• Fever with a rash

• Severe cold or flu symptoms

Learn More About Your Coverage

For more insights on your coverage options, check out Covered California’s easy-to-follow guide on how to use your health plan.

Get Covered

The best way to have all of these options available is to sign up for coverage through Covered California. Four out of five enrollees get financial help to pay for their health insurance.

You can get started here — or get expert help to understand your options at any time.

Accessible Version of Your Health Care: Where, When & Why Infographic