Call 911 or go to the closest emergency room anytime you have a life-threatening emergency. If you’re not sure it’s an emergency, call your doctor’s office for advice.
A guide to whether it’s an emergency is if your symptoms are so severe that you believe not getting medical care right away could place your or someone else’s health (or the health of an unborn child) at risk OR cause major harm to a body function or part.
Examples of an emergency include, when someone:
- May die
- Has chest pains
- Cannot breathe or is choking
- Has passed out or is having a seizure
- Is sick from poisoning or a drug overdose
- Has a broken bone
- Is bleeding a lot
- Has been attacked
- Is about to deliver a baby
- Has a serious injury
- Has a severe burn
- Has a severe allergic reaction or has an animal bite
- Has trouble controlling behavior and without treatment is dangerous to self or others
If you feel you’re having an emergency, you don’t need an OK from us or your PCP to get care.
An urgent medical condition is not an emergency, but needs medical care within 24 to 48 hours.
Here are some examples of urgent medical conditions:
- Ear aches
- Fever
- Stomach pain
- Vomiting
- Minor burns
- Sprains
Yes. You are covered for emergency or urgent care even if you are outside of our service area. It's helpful if you find the hospital and urgent/walk-in center nearest your home and call to ask if they have a contract with your health plan. (Do this before an emergency or urgent situation arises.)
Go to the nearest health care facility. Call your doctor or us within 24 hours, or as soon as you can. When your care is done, you will need to pay the bill. (You may want to use a credit card. The credit card company will automatically transfer the foreign currency into American dollars for you.) Keep all your receipts.
When you get home, call us at the number on the back of your member ID card or stop by your employer's personnel office and ask for a claim form. Fill out the claim form and submit it with your receipts to our address on the form. (The amount submitted must be in American dollars). We will pay you back based on your health plan benefits.
