Medica Choice Network developed the following to help healthcare consumers to select a medical provider to meet their medical needs and condition.  The prices stated below are based on the allowed amount of claims sent to Medica Choice. Allowed Amount Defined:  The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” If your provider charges more than the plan’s allowed amount, you may have to pay the difference and if the your plan is not in network you, you will pay more.

Cost Key:
Lower Cost, Medium Cost, Higher Cost, Highest Cost
Condition Virtual Care/E-visit Convenience Care* Primary Care Clinic Urgent Care Emergency Department
Allergies $42 $79 $191 $200 $733
Bronchitis, Acute $42 $78 $174 $242 $1,074
Earache $42 $78 $174 $229 $779
Pink Eye $42 $75 $140 $184 $621
Sinusitis, acute $42 $81 $163 $220 $1,069
Sinusitis, chronic $42 $88 $216 $295 $1,154
Strep Throat / Tonsillitis $42 $87 $168 $231 $1,043
Urinary Tract Infection $42 $79 $177 $247 $1,264

*Convenience care sites are usually staffed by licensed providers such as a nurse practitioner and do not typically have a medical doctor on site.

Virtual Care/E-visit

Virtual care, also known as online care or an e-visit, is a convenient way to get care for many common conditions. Connect with a provider from your computer or mobile device to get a diagnosis, treatment plan and prescription (if needed).

Note: virtual care is different than receiving care via telemedicine. With telemedicine, you go to a doctor’s office or other health care facility and connect with a provider at another location using the phone, internet or another mean

Fast Facts

  • For a limited number of common minor ailments
  • Not for emergencies
  • Not designed to provide continuous/follow-up care or treatment
  • Visits are often available after clinic hours, sometimes even 24/7
  • You don’t need an appointment

 

Convenience Care

Convenience care sites (MinuteClinic® is an example) usually are located in grocery stores, shopping malls, pharmacies and other retail stores.

 

Convenience care sites are staffed by licensed providers who can diagnose and recommend treatment for certain minor illnesses such as sore throats and ear infections for people older than 18 months.

Fast Facts

  • For a limited number of common minor ailments
  • Not for emergencies
  • Not designed to provide continuous/follow-up care or treatment
  • Open weekdays and often weeknights, weekends and/or holidays
  • Staffed by licensed providers such as nurse practitioners. (Note: A medical doctor is not usually on site.)
  • Patient must be older than 18 months
  • You don’t need an appointment

 

Doctor’s Office/Primary Care Clinic

For non-emergency situations, it’s best to go to your primary care doctor or clinic for care. Your doctor knows you and your health history; has access to your medical records; and can provide follow-up care or refer you to specialists if necessary. Many primary care clinics offer extended hours and weekend appointments. And most clinics have staff on-call after hours that can help you get the care you need.

Fast Facts

  • For comprehensive care of illnesses and injuries as well as preventive, routine and chronic care
  • Not for emergencies
  • Open weekdays and may be open some weeknights and/or weekends
  • Staffed by doctors, nurses and other licensed providers
  • If possible, you should call in advance for an appointment

 

Urgent Care Center

Urgent care centers offer a readily accessible care option for minor ailments that require immediate attention. Urgent care centers are staffed with doctors and nurses who can care for a variety of illnesses and injuries, including sprains and strains, minor broken bones, mild asthma attacks, minor infections and rashes, small cuts, ear infections and sore throat

Fast Facts

  • For minor ailments that require immediate care
  • Not for emergencies
  • Not designed to provide continuous/follow-up care or treatment
  • Open weekdays and often weeknights, weekends and/or holidays
  • Staffed by doctors, nurses and other licensed providers
  • You don’t need an appointment

 

Emergency Department

Emergency departments are located in hospitals. The emergency department is for true medical emergencies. You should not go to an emergency department for minor problems. If you do, you may have to wait a long time because patients with true emergencies are treated first. In addition, emergency care for minor procedures can be more than 10 times as expensive as other care options.

Some examples of when you should go to an emergency department include:

  • Heavy bleeding
  • Large open wounds
  • Warning signs of stroke: sudden dizziness or change in vision, sudden weakness or numbness, trouble speaking or understanding speech
  • Chest pain
  • Major burns
  • Severe head injury

 

Fast Facts

  • For serious or life-threatening health issues
  • Open 24 hours a day, 365 days a year
  • Staffed by doctors, nurses and other licensed providers
  • You don’t need an appointment

 

If your situation seems life-threatening, go to an emergency department immediately or call 911.

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