February 11, 2013

Including the cost of diagnostic procedures in Urgent Care Copay

It would benefit BCBS if while simultaneously urging their members to take advantage of lower cost alternatives to the ER they implemented policies to reduce the cost to the patient. I recently opted to go to Urgent Care instead of the ER while having chest pains, but because I had yet to meet my annual deductible and BCBS treats the X-Ray and the actual visit as separate events; my total out of pocket cost was greater than my ER co-pay. I would have been burdened less financially from a trip to the hospital, but BCBS saved thousands. That's counterproductive.


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Susan Menendez

Susan Menendez commented on February 14, 2013

Dir., Provider Relationships

Bobby, We hope you’re feeling better and appreciate you sharing your recent experience with urgent care.

According to our data, the average out-of-pocket cost in North Carolina for an urgent care visit is $54. It obviously sounds like your experience was well above the average. It is important to keep in mind that there is the possibility that the ER visit could have been as much as ten times higher than your urgent care visit depending on the tests, attending physicians, and procedures used during the ER visit. How was your experience, and do you think it may have saved you some time compared to a couple hours wait in the ER?

BCBSNC has set up a website, www.bcbsnc.com/urgent, that features information for anyone who wants to know their options for various types of care based on symptoms, potential costs and wait times. We encourage everyone to understand their alternatives in order to consider the most appropriate level of care and the most cost-effective choice.