Where To Go When You Need Care

Emergency room doctor talks with young girl and the girl's mom about the girl's injured ankle. The doctor is pointing to the girl's wrapped ankle.

Your Anthem Care Options: Primary Care, Urgent Care, And More

 

When you are sick or injured, there are many options for care, depending on your medical needs. Calling your primary care doctor should always be your first choice for care. If your doctor isn’t available and it’s an urgent medical concern, you still have options besides the wait and cost of an emergency room (ER) visit. 

 

A virtual visit with a doctor, a retail health clinic, or an urgent care center available to Anthem members are all convenient and less expensive than a trip to the emergency room. Going to the ER or calling 911 is always your best option for emergencies.

Select Care Based On Your Needs1

Care Choices Infographic

When To Choose The Doctor’s Office

 

Your doctor’s office is a great place for scheduled care and check-ups, and you should try them first during office hours in a non-life-threatening emergency. Doctors are usually available during normal business hours and may also provide medical advice by phone after hours. Many doctors are also offering virtual visits through their offices.

 

A good choice for: 

 

Mild asthma, back pain, flu-like symptoms, allergies, fever, sprains, diarrhea, eye or sinus infection, rash, urinary tract infection, sore throat, earache, bumps, minor cuts and scrapes, and other non-emergency symptoms.

 

Find A Doctor

 

When To Choose Virtual Care

 

See a doctor or therapist without leaving your home for non-emergency medical issues. Virtual care provides 24/7 availability with no appointment needed. You can access virtual care by logging in to your Anthem account or through your SydneySM Health app.

 

A good choice for: 

 

Flu-like symptoms, allergies, fever, sinus infection, diarrhea, eye infection, skin infection, rash, urinary tract infection (UTI).

 

When To Choose A Retail Health Clinic

 

Visit your local retail clinic for flu shots or help with mild rashes, fevers, or colds. Walk-in care clinics are located in certain drugstores and major retailers.

 

A good choice for: 

 

Sore throat, earache, bumps, minor cuts and scrapes, urinary tract infection.

 

When To Choose Urgent Care

 

Urgent care locations available to Anthem members are accessible in many communities at all hours of the day and night. Doctors and nurses can help with non-life-threatening but urgently needed care quickly. They are typically standalone facilities with extended hours. 

 

A good choice for: 

 

Sprains and strains, nausea or diarrhea, ear or sinus pain, minor allergic reactions, cough, sore throat, minor headache, urinary tract infection.

 

Find An Urgent Care Location

 

When To Choose The Emergency Room

 

You should always go to the ER if you believe your life or health is in danger. However, for less severe injuries or illnesses, the ER can be expensive and wait times can average over 4 hours. 

 

Always call 911 or go the ER if you think you are having a real emergency or if you think you could put your health at serious risk by delaying care.

 

A good choice for: 

 

Signs of a heart attack (chest pain) or stroke (sudden numbness and slurred speech), difficulty breathing, and severe burn or bleeding. Any other symptoms where it is reasonable to think you are having a life-threatening emergency or your health is in serious jeopardy.

 

Find All Types Of Care From Your Phone

 

Log in or download the SydneySM Health mobile app. Then, you can:

  • Find a doctor. 
  • Have a virtual visit with a doctor 
  • Find a retail health clinic, urgent care center, or ER.

 

Choose Find Care and follow the steps.

 

 

Infographic Transcript

 

PCP

Usually available during normal business hours and may also provide medical advice by phone after hours

 

(doctor icon)

 

cost7

$$

average wait2

18 min

 

Mild asthma, back pain, flu-like symptoms, allergies, fever, sprains, diarrhea, eye or sinus infection, rash, urinary tract infection (UTI), sore throat, earaches, bumps, minor cuts and scrapes, and other nonemergency symptoms

 

 

Virtual care

24/7 access to doctors through the SydneySM Health app, no appointment needed

 

(doctor in tablet icon)

 

cost

$

average wait3

10 min

 

Flu-like symptoms, allergies, fever, sinus pain, diarrhea, eye infection, rash, UTI

 

 

Retail health clinic

Walk-in care clinics located in certain drugstores and major retailers

 

(doctor with clipboard icon)

 

cost

$$

average wait4

30 min

 

Sore throat, earaches, bumps, minor cuts and scrapes, UTI

 

Urgent care center

Stand-alone facilities, open extended hours

 

(nurse with clock icon)

 

cost

$$$

average wait5

30 min

 

Sprains and strains, nausea, diarrhea, ear or sinus pain, minor allergic reactions, cough, sore throat, minor headache, UTI

 

Emergency room

Stand-alone facilities or part of hospitals, open 24/7

 

(hospital icon)

 

cost

$$$$

average wait6

90 min

 

Signs of a heart attack (chest pain) or stroke (sudden numbness and slurred speech), difficulty breathing, and severe burn or bleeding — and any other symptoms where it is reasonable to think you are having a life-threatening emergency or your health is in serious jeopardy.

 

1 The care options and list of symptoms are not all-inclusive. If possible, consult your PCP for more guidance.

 

2 Business Wire: 9th Annual Vitals Wait Time Report Released (accessed July 2021): businesswire.com.

 

3 LiveHealth Online, internal data 2020.

 

4 Healthcare Finance: Patient wait times show notable impact on satisfaction scores, Vitals study shows (accessed July 2021): healthcarefinancenews.com.

 

5 Urgent Care Association: UCA 2019 Benchmarking Report (accessed July 2021): ucaoa.org.

 

6 Harvard Business Review: To Reduce Emergency Room Wait Times, Tie Them to Payments (accessed July 2021): hbr.org.

 

7 Costs are ranked according to the member’s estimated out-of-pocket costs and average health plan copays. Each plan may have different costs. Nonemergency care outside of your network may cost more out of pocket or may not be covered at all. $ = lower cost, and $$$ = higher cost.

 

Call the Member Services number on your ID card if you have questions about your plan.