What are emergency conditions and services?

An emergency condition is when you are experiencing extreme or sudden pain or have acute symptoms that require immediate medical diagnosis, care and treatment to avoid disability or death.

Emergency services are those required for an acute medical condition in which a prudent layperson could reasonably expect the absence of immediate medical attention to result in serious jeopardy or harm.

If you have an emergency situation, call 911 or go to the nearest emergency room no matter where you are located. You do not need pre-approval from your physician for initial ER care, but related follow-up care should be provided through your primary care physician.

What are urgent care conditions and services?

Urgent care means services that are medically required within a short-time frame, usually within 24 hours, in order to prevent serious deterioration of a member's health due to an unforeseen illness or injury.

How do I get urgent or after-hours care?

If you need medical services after your doctor’s office is closed, follow these steps:

  1. Call your doctor’s office.  Your doctor or the doctor on-call will instruct you to seek care at the emergency room, your medical group's contracted urgent care center, or on home care remedies.
  2. Call Nurse24.  If you have a medical concern and are not sure what to do, you can call our nurse advice line at 877.793.3655. Nurse24 is available 24/7 so you can call any time of the day or night.
  3. Be prepared.  Know the contact information and location of the closest emergency room, your medical group’s urgent care center, poison control, and closest friend/relative.