When to Use the ER

Office Visit vs. an ER Visit

Home State understands that you may have health conditions that need immediate attention. Many times the condition may require a visit to an emergency room (ER). How do you determine if or when you or a loved one should go to the ER?

If you think that you or a family member is having a medical emergency, go to the ER to see a healthcare provider right away. Call 9-1-1 if the person’s condition needs immediate attention where you are. For non-emergencies, please contact your Primary Care Provider (PCP). Or speak with an on-call staff member. You may also call our nurse advise line for assistance. The number is 1-855-694-HOME (4663).

To find an urgent care in your area visit Find An Urgent Care

Medical conditions that generally do not require an ER visit*:

  • Pulled or strained muscle.
  • Vomiting or diarrhea that doesn’t stop. Call your PCP or NurseWise if vomiting or diarrhea do not go away.
  • Earaches.
  • Minor cuts in which bleeding has been stopped.
  • A bite from an animal that has stopped bleeding (you should still call your PCP).
  • Broken bone (first contact your PCP, if possible; otherwise go to the ER).
  • A sunburn or minor burn.
  • Sting or bite from an insect (unless you experience labored breathing, in that case go to the ER or call 9-1-1 immediately).
  • Fever that won’t go away (if you are convulsing, then go to the ER). Call your PCP or NurseWise if a fever will not go away.
  • Sexually-transmitted diseases (STDs).
  • Adult colds, kid colds and cough, sore throat, or flu symptoms.
  • A rash that won’t go away

Routine medical visits may include:

  • Child immunizations.
  • Child wellness check-ups (HealthChecks).
  • Important health maintenance visits (including mammograms, pap and pelvic exam and prostate exam).
  • Follow-up visits for chronic problems such as diabetes and high blood pressure.
  • Prenatal (pregnancy) visits.
  • Smoking cessation (quit smoking counseling or medication).

Home State supports each member and family member in their decision for medical care. Always get immediate medical attention if you think you or a loved one is having a medical emergency. Call 9-1-1 if the person’s condition needs immediate attention where you are.

Approval Date: March 18, 2014
Approval Code: HSHP14078