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Costs for different types of health care

Type of CareCost of careWhen should I use this type of care?Examples

Primary care

Care from your regular doctor or nurse, also called primary care provider or PCP for short.

$ – $$

Your cost for each visit will depend on your plan. For preventive care, you will not have to pay. You will pay a copay or coinsurance for other primary care visits based on your plan. Some plans have you pay the full bill until you reach your deductible.

Use when you need routine care or care for non-emergency problems during daytime office hours.

  • Yearly checkup

  • Yearly screenings, such as for blood pressure or cholesterol

  • Flu shot

  • To manage chronic issues like high blood pressure or asthma

Specialty care

Care from a doctor who is an expert in an illness or health problem, also called a specialist.

$$ – $$$

Specialty care usually costs more than primary care. Your cost for each visit will depend on your plan. You’ll pay a copay or coinsurance based on your plan. Some plans have you pay the full bill until you reach your deductible.

You may need to see a specialty care doctor for a specific health problem, like cancer or joint pain.

For some plans, you need a referral from your primary care doctor or nurse to see a specialist.

  • Cancer care (oncology)

  • Heart problems (cardiology)

  • Therapy for depression, anxiety, or addiction

Urgent care centers

You will pay full price for out of network care.

$ – $$$

Urgent care costs less than going to an emergency room. Check to see if the urgent care center is in your health insurance plan’s network.

Urgent care is a doctor’s clinic for problems that need to be treated right away, but aren’t life-threatening.

It lets you get care faster than if you wait to see your regular doctor or nurse. Many are open longer hours than primary care, 7 days a week.

  • Twisting your ankle

  • Cuts that might need stitches

  • Eye infection

Emergency department

Also called an emergency room or ER for short.

$$$$

If you get emergency care, you may pay a large copay, coinsurance, or both. This depends on your plan and what care you need.

Emergency care is care you need right away for a problem that could be life-threatening.

  • A heart attack

  • A car accident

  • A broken bone

Hospital stays

When you stay for 1 or more days in a hospital.

$$$$

Your cost will depend on whether you go to a hospital that is in-network or out-of-network. You will pay a copay or coinsurance based on your plan.

You may need to stay in the hospital after a surgery or health emergency. If you have time to plan before a hospital stay, ask your doctor what you should bring with you.

  • Surgery

  • Care overnight after visiting the emergency room