What to do in an Emergency

After-hours care, urgent care and medical emergencies

You may have occasions when you need to seek help immediately. This may be as simple as advice from your PCP or from someone on their staff, like an advice nurse, even if it after normal business hours at their office. Or it may be more urgent and you need to get assistance in person at an urgent care clinic. There may be also times when your need is life-threatening, such as a possible heart attack, broken bones or bleeding that does not stop.

Below is information on each of these type of emergencies, what to do and whom to call.

After-hours care (evenings, weekends and holidays)

Your Health Share PCP looks after your care 24 hours a day, seven days a week. Even if the PCP’s office is closed, call your PCP’s clinic phone number. You will speak with someone who will contact your PCP, or give you advice on what to do.

Sometimes your PCP may not be available. They will make sure another provider is always available to give you care or advice.

What to do in urgent situations

1. If you have a serious illness or injury that requires quick attention, you may go to an urgent care clinic. Urgent care clinics are open seven days a week, beyond regular primary care office hours.

You may visit an urgent care clinic if you have a serious illness or injury that requires quick attention. Always call your PCP’s office before you go to an urgent care clinic. You can call 24 hours a day, seven days a week.

2. Ask to speak to the clinic nurse or on-call provider.

3. A health care provider will tell you what to do. You may be scheduled for an appointment.

If you get sick when you are away from home, call your PCP. If you need urgent care, find a local doctor who will see you right away. Ask that doctor to call your PCP to coordinate your care.

If you have a medical emergency

Emergencies are very serious medical problems. You need help right now to save a life or prevent an injury to a body part for yourself, your child or your unborn child.

Examples of emergencies are:
• Possible heart attacks.
• Loss of consciousness.
• Seizures.
• Broken bones.
• Severe burns.
• Bleeding that does not stop.
• A mental health situation that might harm you or someone else.

In an emergency, go to the nearest hospital or call 911.

You do not need a prior authorization for emergency services. 

You should go to the nearest hospital emergency room, but click here for information, including locations, on the hospitals in Health Share's network. 

Emergency rooms will care for you until your condition is stable. If you need more care, you may be admitted to the hospital.

The emergency staff will tell you where to go for follow-up care. If you do not receive this follow-up help, contact your PCP on the next business day after you get your emergency treatment.

Post-stabilization care

Post-stabilization care means health care services you get after an emergency and after your condition is stable.

Health Share will pay for post-stabilization care you receive from a hospital. The hospital doesn’t have to be a Health Share plan provider.

Call your primary care provider (PCP) or mental health provider as soon as possible after you receive emergency treatment. Your follow-up care is covered, but it is not considered an emergency. You can arrange for more care if you need it.

Out of town emergencies

If you have a real emergency when you are away from home, call 911 or go to the nearest emergency room.
Your care will be covered until you are stable. For follow-up care after the emergency, call your PCP.

Health Share covers emergency and urgent care any place in the United States.

Health Share does not cover emergency and urgent care if you are outside of the United States, like Mexico or Canada.

Important: Do not go to a hospital emergency room for routine care that your PCP can provide.

For example, the following conditions are not emergencies:
• Common cold
• Constipation
• Diaper rash
• Back pain
• Toothache