Medical emergencies are injuries or sudden (or worsened) illnesses that threaten or could permanently damage your health, or result in a serious medical complication if treatment is delayed. Examples of medical emergencies include seizure, poisoning, sudden pain, chest pain, broken bones, head injury with confusion, loss of consciousness, or shock.
What to do if your emergency requires immediate attention:
Call 911 or go to your nearest hospital or urgent care facility. Emergency Care is appropriate when the absence of immediate medical attention can reasonably be expected to result in placing your health in immediate jeopardy, serious impairment to bodily functions, or other serious medical consequences. IMPORTANT: Follow up care must be provided in network, through your PCP. Routine or elective services provided in an Emergency Room or Urgent Care Center are not covered.
Remember: Hospital emergency rooms and ambulances are only for when you have sudden, serious, or life-threatening illness or injury. If you go to an emergency room, but do not have a true emergency, you may be asked to see your doctor or go to an urgent care center.
Urgent Care/After Hours Care
Urgent Care is defined as medical conditions, illnesses and injuries that are not life-threatening or serious, but require prompt medical attention. Urgent Care provides you reasonable immediate access to medical care for a wide range of conditions from minor injuries and illnesses.
What to do if you need urgent or after-hours care:
- Call your Primary Care Physician (PCP). If you cannot reach your doctor, you can call your health plan's 24-hour health advise and concern line, if available. Look on your membership card for available phone numbers.
- If you have a medical problem that requires attention, use one of PMGSJ’s Urgent Care Centers. Refer to our After Hours and Urgent Care listing for additional information. Click Here for List
Out of Area (OOA)
If you are out of the area:
- In the event of a life-threatening medical emergency, call 911 or go to the nearest Hospital Emergency Room.
- For non-emergency medical assistance, call your Health Plan first (if possible) for instructions.
Non-Emergency Care / If you become Sick/Ill
- Call your PCP doctor to schedule an appointment. Your doctor is available or has coverage 24 hours a day either in the office or by telephone.