Arizona Heath
plans
may cover
emergency care, even
if you do not go to
a hospital in your
plan's network. Any
emergency room must
treat you until you
are well enough to
be moved to a
hospital in your
health plan's
network. Your plan
must also cover
emergency care when
you
travel outside
of your plan's
service area.
What Is an
Emergency?
The law says that it
is an emergency if
you reasonably
believe that it is
an emergency. It is
an emergency if
waiting to get care
could be dangerous
to your life or a
part of your body. A
bad injury or a
sudden serious
illness can be an
emergency. Severe
pain and active
labor are also
emergencies. Your
Arizona health plan may
cover emergency care
no matter where you
are and what
hospital you go to.
However, you may be
moved to a hospital
in your health
plan's network when
you are stable
enough to be moved.
What Is Urgent Care?
Urgent care is care
you need within 24
to 48 hours. Your
health plan must
cover urgent care
when you travel
outside your plan's
service area. If you
are within your
plan's service area,
you must use doctors
in the network for
urgent care.
Be Prepared Ahead of
Time
-
Ask your primary
care doctor what
to do if you or
your child needs
urgent care.
-
Ask your primary
care doctor or
call your health
plan to find out
where you can go
for urgent care
or other
after-hours
care. You can
also find out
about urgent
care in your
Evidence of
Coverage.
Tips
-
If you can, call
your doctor or
an advice nurse
before you go to
the hospital.
Ask what you
should do.
-
Keep your
Membership Card
with you at all
times.
-
If your plan
will not pay for
the emergency or
urgent care you
received, you
can
file a complaint
with your plan.
