In a medical emergency, please follow the steps below to receive your care at the in-network level and save on medical costs:

1. Go directly to the nearest emergency room or call 911 or your local emergency response number.
2. Call your PCP if possible.
   Your PCP can assess your situation and advise you of the best course of action.

If you or your authorized representative is unable to call before your visit to the emergency room, we encourage you or your authorized representative to call as soon as possible after your visit, so that your doctor is kept aware of your condition.

Please note: You may have an emergency room copayment, even if your PCP refers you. Each time you receive treatment in an emergency room for a medical emergency or for a medical emergency screening exam, you will be responsible for this copayment. If you are admitted as an inpatient, we’ll waive the emergency room copayment.*

* Some Administrative Services Only (ASO) groups may not have an emergency room copayment. Please refer to your Benefit Certificate/Booklet for additional information.

If you are hospitalized, your doctor must contact us for prior authorization for your services to be covered at the in-network level. If your care is rendered by a nonparticipating doctor, you must call Member Services to obtain prior authorization for services rendered.

Follow-up care after an emergency room visit

To be covered at the in-network level, all medical emergency follow-up care should be coordinated by your PCP.