Helping newcomer clients navigate the U.S. health care system is both practical and important. This blog breaks down the five types of care, offers guidance on when to direct clients to each one, and includes client-facing resources to help newcomers orient themselves.
For refugees and other newcomers, the U.S. health care system may look different from that in their home countries. As service providers, you may need to coach clients as they begin to navigate the U.S. health care system. This includes answering important questions, like where to go for specific health needs or how to avoid unnecessary costs. A valuable place to start when coaching clients is identifying the different types of care: primary, mental health, specialty, urgent, and emergency.
1. Primary Care: Main Point of Contact
Primary care is the foundation of the U.S. health care system. Primary care providers (PCPs) include doctors, nurse practitioners, and physician assistants who:
- Provide regular checkups and preventative care
- Treat common illnesses
- Manage ongoing health conditions
- Give vaccines
- Refer patients to specialists, if needed
A person can access primary care for:
- Annual or routine checkups
- Vaccinations
- Mild illnesses (colds, stomach pain, headaches)
- Managing long-term conditions like diabetes or high blood pressure
- Children’s school physicals
In some cases, newcomers will have their domestic medical screening with a primary care provider.
Tip: In the U.S., people are encouraged to see a primary care provider even when they feel well. Regularly seeing the same PCP establishes an ongoing relationship and helps the provider become familiar with the patient’s health history and needs. Early testing can catch health issues before they become serious, and prevention services can help people stay well for longer. Some newcomers may be less familiar with preventative care. Providing culturally and linguistically appropriate health education about the purpose and benefits of preventative care can be helpful.
The U.S. health care system strongly adheres to confidentiality.
- For adults, confidentiality is between the provider and the individual adult patient. Spouses and other family members may therefore be asked to leave the clinic room so the provider can speak privately with the adult patient. Health care providers cannot discuss or give details about an adult’s health to family members unless the patient has completed a consent form specifically listing the individuals who are allowed access to their health information.
- For adolescents, their parents may be asked to leave the clinic room so the provider can speak directly with the adolescent patient. These requests are made to help health care providers build trust with the adolescent.
- Patients also have the right to a trained medical interpreter who is not their family member. The interpreter must also adhere to confidentiality.
2. Mental Health Care: Support for Emotional Well-Being
Mental health care is an important part of overall health and can be accessed at multiple levels, including through a PCP.
Mental health services may include:
- Counseling or therapy
- Treatment for depression, anxiety, or trauma
- Support for children and adolescents
Clients can often start by talking to their primary care provider, who can offer care or a referral to a mental health specialist. You can also speak to these providers about other options for emotional well-being and mental health care, such as peer support groups, trauma-informed yoga, etc. Many resettlement agencies have programs that are focused on psychosocial support other than traditional therapy. Service providers can check with their agency to learn about what programs are available, the eligibility requirements, and the referral process.
3. Specialty Care: Seeing an Expert
Specialty care focuses on specific parts of the body or certain conditions.
Specialists are providers with advanced training in one area. Some examples of specialists include:
- Obstetrician/gynecologist (OB/GYN: women’s health, pregnancy, childbirth, and postpartum care)
- Cardiologist (heart)
- Dermatologist (skin)
- Mental health provider
- Eye doctor (Note: check for insurance coverage)
- Dentist (Note: check for insurance coverage)
People often need a referral from their PCP before seeing a specialist, especially if they have Medicaid.
When should someone use specialty care?
- When their primary care provider identifies a health issue that requires evaluation and management beyond the scope of the PCP
- For conditions that need expert treatment (e.g., oncology for cancer, surgery for surgical intervention, etc.)
- For follow-up care after testing or diagnosis
Tip: Not all specialists accept all insurance plans. Clients should always confirm that the provider accepts their insurance before scheduling.
4. Urgent Care: When You Need Care Quickly (But It’s Not an Emergency)
Urgent care clinics are for health problems that need attention soon but are not life-threatening. Urgent care is often available in the evenings and on weekends when primary care clinics are closed. Urgent care is also usually less expensive and faster than the emergency room.
Urgent care can be used for:
- Minor injuries (sprains, small burns, cuts)
- Fever or flu symptoms
- Ear infections
- Urinary tract infections
- Mild breathing concerns
- Concerns about COVID-19, flu, or respiratory syncytial virus (RSV)
When should a person choose urgent care?
- When they can’t get a timely appointment with their primary care provider
- When the issue cannot wait a few days, but it is not severe
Tip: Clients (with their service provider’s assistance, if needed) can ask their PCP for an urgent care recommendation or check with their health insurance to find one that is covered. Often, PCP clinics have a nurse line that patients can call to provide details about their symptoms and receive advice on whether they should schedule an appointment or seek urgent (or emergency) care.
5. Emergency Room (ER): Life-Threatening Situations
The emergency room at the hospital is for serious or life-threatening medical problems. In an emergency, call 911. Clients can:
- Ask for an interpreter
- Say what language they speak
- Request an ambulance if needed
When should someone go to the ER?
- Chest pain or pressure
- Difficulty breathing
- Signs of stroke (e.g., severe headache, weakness, slurred speech)
- Seizures
- Serious head injuries
- Heavy or uncontrolled bleeding
- Severe abdominal pain
- High fever in babies or very young children
Clients who are parents of younger children should know to seek emergency care if their child:
- Is unusually sleepy or hard to wake up
- Is not eating or drinking
- Is not urinating or using the bathroom normally
Tip: Ambulance rides may not always be fully covered by insurance. But it is always better to be safe than sorry. Clients should seek emergency care if they feel their life is in danger, even if it is unclear if the ambulance ride or emergency room visit will be covered by insurance.
Help Clients Build Confidence in the System
Learning about the different types of care helps newcomers feel more confident and empowered when navigating the U.S. health care system. While the system can be complex, understanding where to go and when to go there makes a big difference in staying healthy and minimizing stress.
Resources for Orienting Clients
Understanding the different types of care is a great first step, but you may be wondering how to actually put this knowledge to work with your clients. How do you explain the difference between urgent care and the ER to someone who has never encountered either? How do you help a client who is used to a very different system, or one where any medical visit feels high-stakes? The resources below offer tools, guides, and frameworks to help you have these conversations.
Settle In:
- Healthcare in the U.S.
- Your Rights and Responsibilities in the U.S. Healthcare System
- Navigating Healthcare Part 1: Healthcare Providers and Services
- Navigating Healthcare Part 2: Emergency Care and 911
Switchboard:
- Going to the Pharmacy Virtual Reality 360 Video
- Assisting Newcomers with Navigating the U.S. Health System
Migration Health Initiative: Healthcare Navigation
Society of Refugee Healthcare Providers: Directory of Refugee Healthcare Providers
Minnesota Center of Excellence in Newcomer Health: Newcomer Education for Wellness Video Series
The IRC received competitive funding through the U.S. Department of Health and Human Services, Administration for Children and Families, Grant #90RB0053. The project is 100% financed by federal funds. The contents of this document are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services, Administration for Children and Families.
