Emergency care

​For emergency services, all medical options pay 80 percent of covered charges after the deductible is met. In all instances, you are responsible for paying your deductible and copayments.

​If you are in need of emergency care:

  1. Call 911 and get the care you need from the nearest provider or hospital emergency room (ER), regardless of whether it is a network facility or out-of-network and whether you have the PPO, EPO, or HDHP option.
  2. Within 48 hours of an inpatient emergency admission — for an illness or injury or behavioral health or substance use disorder treatment — call the toll-free number on your medical ID card to certify your stay and maximize your benefits.

If you go to an ER and are admitted to an out-of-network hospital or other facility, once the emergency is addressed, you may need to transfer to a network provider to continue to receive the network level of benefits.

Note: Admissions to behavioral care and substance use disorder programs and facilities must be pre-certified.

Alternatives to the ER

Consider alternatives to a hospital emergency room if taking the time to examine your options will not put your health at risk. Other sources of medical care are

  • your primary care physician;
  • the 24-hour nurse line listed on your medical ID card;
  • the Teladoc telemedicine benefit (800-835-2362);
  • urgent care centers (freestanding health clinics staffed by physicians);
  • retail medical clinics (typically in a pharmacy and staffed by certified nurse practitioners).