Use an emergency room only when you have a serious medical issue and it is not safe to wait. If you wait, emergencies could mean permanent harm or death. Use the hospital emergency room that is nearest to you.
If you feel your medical problem is an emergency, call 911 or go to the nearest emergency room right away. For a real emergency, you don’t need to call your doctor before you go.
If you are not a U.S. citizen or qualified alien, you may still be eligible for Medicaid assistance under the Emergency Medicaid Program. Coverage under Emergency Medicaid is limited to emergency services only.
Emergency Services for Members Enrolled in an Accountable Care Organization
Accountable Care Organizations (ACO) are responsible for covering all emergency services for enrollees. It does not matter where the emergency occurred and was treated. Emergency services must be provided when a sudden medical condition could result in one of these three conditions:
- The patient’s health is in serious jeopardy
- Serious impairment of bodily functions
- Serious dysfunction of any bodily organ or part