Where to go when you are sick

In the U.S., where you go for the same illness changes the bill dramatically. Knowing the four options before you need them is worth real money, because the choice is made badly at two in the morning by someone who is frightened and has not looked any of it up.

Community clinic

$20–$40 on a sliding scale, no status questions

Urgent care

$100–$200 uninsured, evenings and weekends

Emergency room

$1,000–$3,000 without admission

Interpretation

Free, and a right, at any federally funded provider

The four options

Primary care doctor — for anything ongoing, routine, or not urgent. Register with one before you are ill; new-patient appointments are often weeks out. Typical cost with insurance: a copay of $20–$50. See finding a doctor.

Community health center (FQHC) — federally funded clinics that must treat everyone regardless of insurance or immigration status, charging on a sliding scale based on income. Often as little as $20–$40 for someone with no insurance. These are the single most useful resource for uninsured families, and most people have never heard of them.

Urgent care — for problems that need attention today but are not dangerous: infections, sprains, stitches, high fever. Open evenings and weekends. Typically $100–$200 without insurance.

Emergency room — for genuine emergencies: chest pain, difficulty breathing, serious bleeding, stroke symptoms, severe injury. Never turned away, but the most expensive care in the system by a wide margin. A visit with no admission commonly bills $1,000–$3,000.

Two more options most people miss

A nurse advice line. Most insurers run one 24 hours a day, free, and the number is on the back of your card. A nurse will tell you which of the four options your symptoms call for. It is the cheapest way to answer the question this page is about.

Telehealth. A video appointment, often $0–$50 and available within the hour, handles a large share of what people take to urgent care: rashes, urinary infections, coughs, prescription renewals. Many insurers cover it entirely.

Pharmacies also treat more than people expect — vaccinations, blood pressure checks, and in many states minor prescriptions.

Emergency treatment is a legal right

Under federal law, any hospital emergency department that accepts Medicare — which is nearly all of them — must screen and stabilise anyone with an emergency condition, regardless of insurance, ability to pay, or immigration status. You may be billed afterwards, but you cannot be refused treatment or turned away at the door.

Emergency Medicaid exists in every state to pay for emergency treatment for people who meet the income rules but not the immigration ones. Ask the hospital's financial counsellor about it before you agree to any payment plan — a bill you have been given is not the same as a bill you owe. See understanding medical bills.

Language help is also a right

Hospitals and clinics receiving federal funds must provide interpretation free of charge. Ask for an interpreter in your language — you are entitled to one, and you should not rely on a family member, least of all a child, to translate a medical conversation.

If you are told none is available, ask for the patient advocate or the interpreter services line. Both exist at any hospital of reasonable size.

Prescriptions

Prices for the same medicine differ enormously between pharmacies, and the "cash price" is sometimes lower than the insured price. Free discount-card services can cut the cost of common generics by 50–80%. Always ask the pharmacist whether a generic is available, and whether a 90-day supply is cheaper than three monthly ones.

Bring the generic name of anything you already take rather than the brand — brand names differ between countries, and the active ingredient is what a U.S. pharmacist can work from.

Before you need any of this

Save five things in your phone: your insurance member ID, your insurer's nurse line, the nearest emergency room, the nearest urgent care, and the nearest community health center. Do it now, not when someone is ill.