Preventive care is routine care. Examples of preventive care include well-baby checkups, immunization and booster shots, annual gynecological exams, physicals and mammograms. Pennsylvania law requires all individual and group health plans to pay for childhood immunizations, annual gynecologic exams and routine pap smears. Although these services must be paid for, some traditional health plans may not pay for the office visit to receive these services. Most managed care plans pay for both the services and the office visit, but require you to pay a small co-payment.
Urgent care is defined differently from emergency care.
Urgent care is considered care that you need when you have an illness or injury, such as a broken bone. Emergency care is care that you seek in a life or death situation, such as if you've been involved in a serious accident or if you think you are having a heart attack. Most managed care plans will require that you call your primary care physician before you seek urgent care. If you use the emergency room for what is considered a routine physician visit, you will be responsible for paying the bill. In an emergency, you should go immediately to the hospital and call your primary care physician later when your condition has stabilized, or have a family member call as soon as possible.