Emergency Care 

What should I do in an emergency? 
A medical emergency is any situation that needs immediate medical attention and seriously threatens your health. If you are able, call your HMO and get permission to use emergency services. If you are unable to call until after the treatment, do so as soon as you can. 

Remember, if you reasonably believe that you have an emergency medical condition that needs immediate medical care, the HMO has to pay for the care. If the HMO refuses to pay, you can file a grievance or request a fair hearing. 
See  REQUESTING A FAIR HEARING or FILING A GRIEVANCE 

What is considered an emergency? 
  

Examples include:  Heart attack Stroke Heavy bleeding Coma Serious fracture Crushing injuries Severe abdominal pain

Severe asthma attack Shock Seizures Loss of consciousness Choking Serious allergic reactions Serious shortness of breath Active labor

  
What happens if the situation is less severe? 
A medical problem that is less severe is called an urgent situation. An example would be a sprained ankle, a minor burn, a fever or a cut needing stitches. In an urgent situation, always call your HMO first for specific instructions.