Check Your Benefits

Find an in-network provider and review your benefits to get the right care for the least amount of out-of-pocket cost.

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I Need Care! Where Do I Go?

It's hard to know where to go for care when you're sick or injured. Followed these tips to get the best care possible wherever you need it.

We don't know when you're traveling unless you call.

If you are traveling and need urgent care, call us if your claim is applied to out-of-network benefits and we will review it. We don’t know you’re traveling when we get an out-of-network claim. Once we know you were traveling we will apply the appropriate in-network benefit (if applicable).

Call if you're unsure of your best care option.

Call 24/7 Nurse Line at 605-322-1354 for free advice from a registered nurse, including whether to seek immediate attention.

Check your health plan benefits.

We have a secure website so you can find the resources you need, when you need them. This easy-to-navigate portal gives you access to the following resources: in-network provider directory, pharmacy benefit information, and summary of benefits and coverage to find out your co-pay amounts, etc.

A Visual Guide to Care Decisions

Reviewed by TB on August 24, 2018

Minor

Minor InjuriesAveraNow app - *FREE
Use our 24/7 provider video visits to get fast and convenient treatment for: UTI, flu, diarrhea, allergies, rashes, pink eye, etc. It's always free and unlimited with your special coupon code, found on the back for your member ID card. Can be used anywhere in the U.S. Patients must be at least 2 years old.

2018 Avera Health Plans Member Card Back View

*AveraNow qualifies for medical reimbursement as an allowable expense, so you can use your Flexible Spending Account for payment. Check with IRS regulations or your flex benefits administrator every year as eligible items and services can change. If you have a high deductible, HSA-eligible plan, consult your tax adviser on the use of AveraNow for possible tax implications.

Urgent Care

Urgent Care Injuries

Questions to ask yourself based on your situation.

  1. Is it after office hours?
  2. Are you traveling?
  3. Can it wait until the morning?
It Can Wait

Primary Doctor - $
Your primary care doctor knows you best and the clinic is equipped to handle all minor and serious issues. They'll handle care during regular business hours for sickness, injury and preventive services.

Make sure they're in-network or you'll pay more!

I Need Care

Urgent Care - $$
Urgent care is a great option for evening and weekend care but it is not open 24 hours.

They'll handle issues that require immediate attention: minor cuts and burns, sprains and broken bones, respiratory issues.

Emergency

Emergency Injuries

Go to the nearest ER! - $$$
This is the most expensive option; use for critical issues such as chest pain, head injuries, trouble breathing, fevers over 103 degrees in babies 3 months and older.

Details about your out-of-pocket costs for an ER visit are outlined on page 3 in your Summary of Benefits and Coverage located on our member portal. Log in to learn more.