How to Handle Emergencies and Urgent Care Situations

Emergency & Urgent Care medical situations can arise at any time. One should prepare ahead of time to review your insurance coverage. Each insurance plan may have a different treatment protocol you should follow in order to receive immediate medical care that is covered by your insurance plan. Understanding this process in advance means you’ll have less to worry about if, and when, an actual emergency/urgent need occurs.

In life-threatening situations, when every minute counts, call 911 or go directly to the nearest emergency department. Once there, inform the emergency department staff of your health plan and Primary Care Physician (PCP) so that your physician can help coordinate your care. If you are in the San Joaquin Hills Neighborhood, your closest Emergency Departments will either be Mission Hospital or Saddleback Memorial. Please contact your health plan on the appropriate coverage.

In all other situations requiring urgent (but not life-saving) medical attention, it is important to call your PCP for directions. Do not worry if it is a weekend, or after normal work hours. Your primary care doctor at your medical home, or a designated on-call physician, is available by telephone seven days a week, 24 hours a day.

You and your doctor can manage many urgent care situations by phone. However, when a face-to face evaluation is required your doctor will refer you to an appropriate facility. The authorization and referral from your PCP will facilitate insurance coverage for urgent medical treatment at those facilities.

Emergency room visits may require longer wait time because order of treatment is based on severity of your illness, not on your arrival time at the ER. Therefore, urgent care centers are typically a more appropriate and faster means of treating non-life threating, urgent medical conditions when after hours.

Co-Payments for an urgent care visit are generally less than Emergency visits.

Co-payments for emergency room visits are more depending upon your insurance plan. You are expected to pay your co-payment at the of the visit. Remember, hospital emergency rooms usually have a co-pay of $50-$100. Urgent care centers will have a low co-pay of approximately $30-$50.

South Coast Medical Group can be your medical home whether serving as your Primary Care Physician Medical Home or Urgent Care. We have been serving the residents of San Joaquin Hills, Laguna Niguel and Aliso Viejo for over 15 years. We look forward to caring for your family. We accept most PPO and HMO insurances.