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Urgent Care
Urgent care centers offer walk-in care for patients with illnesses or injuries that do not require the intensity of care offered at an emergency room, but typically cannot wait for a scheduled appointment in a physician's office. Examples of some urgent (nonemergency) illnesses include: sprains, ear infections and nonemergency allergic reactions.
If you have an urgent health situation, you may want to contact your family doctor. Typically they have an on-call doctor who is available 24 hours a day.
If you are not able to visit your family doctor, you may want to seek treatment at an urgent care center that participates with Blue Cross Blue Shield of Michigan. Participating centers offer extended and weekend hours.
Visiting a participating urgent care center for nonemergent conditions can save you time and may lower your out-of-pocket costs when compared to a visit to the emergency room. Please consult your specific health plan benefit description for more information.
You may also call the BlueHealthConnection® program at 1-800-775-BLUE (2583) for nurse support.
If you use an urgent care center, please consider the following — there are two different types of urgent care centers:
| Hospital-owned, attached urgent care center | Freestanding or hospital-owned, unattached urgent care center |
|---|---|
| Provider is considered in-network | |
| A hospital-owned urgent care center that is physically attached to the hospital is considered in the BCBSM network if that hospital participates with BCBSM and bills your visit as an urgent care visit. | A freestanding urgent care center or a hospital-owned urgent care center that is not physically attached to the hospital is considered in the BCBSM network if the urgent care center participates with BCBSM. These participating urgent care centers are listed in the BCBSM urgent care center directory. |
| Notes | |
| Depending on your particular health plan, you may have a copayment or other out-of-pocket charges in the outpatient hospital setting. Please refer to your specific benefit plan description for more details about hospital outpatient coverage. | PPO members: you are considered to be in-network if you receive treatment at a participating BCBSM urgent care center network provider. You will not receive any out-of-network penalties. Please refer to your specific benefit plan description for details about your urgent care coverage and applicable cost-sharing rules. |
Frequently asked questions about urgent care
- If I have an earache or other nonemergent condition and I go to an emergency room, what will happen?
- If you have a nonemergent service done at an ER you may incur ER copays and other forms of cost-sharing that are typically higher than when you seek services in a physician's office or urgent care center. In some cases, your benefits may limit the conditions that are considered emergency, which may affect how much you will have to pay for the service.
- How do I figure out if my visit to the urgent care center will be covered?
- If you go to a freestanding or hospital-owned off-campus urgent care center, make sure that the center participates in the network of the particular health plan you have with the Blues. If you go to an urgent care setting attached to the hospital, make sure the hospital participates with the Blues. The Blues has billing rules in place to help ensure that participating urgent care centers bill appropriately for urgent care services. This does not guarantee coverage, but if you have coverage, this will protect you from having to pay for more than your copays and deductibles.
- What will happen if I go to an urgent care center that does not participate with the Blues?
- If you visit an urgent care center that does not participate in the network of your Blues health plan, you may incur higher out-of-pocket cost-sharing for visiting an out-of-network center. Please refer to your specific health plan benefit description for more information.
- Are urgent care centers the same as a doctor's office?
- Unlike a doctor's office, urgent care centers focus on diagnosing and treating injury or illness for unscheduled, ambulatory patients seeking immediate medical attention for nonroutine conditions that are not life-threatening. They offer extended evening and weekend hours. Additionally, these centers generally provide more complex services than a doctor's office.
- How can I find a participating urgent care center?
-
- Visit bcbsm.com.
- Go to Looking for Health Care?
- In the first drop down menu, select Find a Michigan Hospital/Medical Facility.
- Select your plan from the next drop-down menu, Choose a plan*.
- From the Select facility type* drop-down menu, select Urgent Care Center.
Blue Care Network members should visit MiBCN.com for a list of BCN-participating urgent care centers.
