Emergencies

In a true life-threatening emergency, which if not treated right away could put your life in danger, lead to disability or death, or cause harm to you, it is important to get medical care immediately. When you have a true emergency call 9-1-1 to get immediate medical care.

Tips about Emergencies:

• Go to the Emergency Room only when you have real emergencies.
• If you are sick, but it is not a real emergency, call your doctor.

Emergencies can include:

• Poisoning.
• Overdose.
• Severe burns.
• Severe chest pain.
• Pregnant with bleeding and/or pain.
• Deep cut in which bleeding will not stop.
• Loss of consciousness.
• Suddenly not being able to move or speak.

You have the right to go to any hospital or other setting for emergency services. You do not need to call your primary care provider or get a prior authorization to receive emergency medical care.

Most illnesses are not emergencies and can be treated at your doctor's office. You can also be treated at an Urgent Care Center. You should not use an emergency room if you have one of these minor problems:

• Common cold, flu symptoms or a sore throat.
• Earache or toothache.
• Back strain, migraine headaches, prescription refills or requests.
• Stomach ache.
• Cut or scrape.

If you are not sure if your problem is a true emergency, call your doctor for advice. Emergency services will be provided until you are stabilized and released, or admitted to a Health Choice Utah network hospital.

After-hours and Urgent Care
Except in a true emergency, if you have a sudden health problem, call your doctor first!

Even if your doctor's office is closed for the day or on a weekend or holiday, call the office anyway. An answering service will make sure your doctor gets your message. Listen very carefully to the instructions that the answering service gives to you. It might take a little while for your doctor to get back to you, but your doctor will call you back and tell you what you should do.

The doctor's office may direct you to an Urgent Care Center in the Health Choice Utah provider network. Look in your Health Choice Utah Provider Directory for the Urgent Care Centers near to your home.

Important: You may be charged a $6.00 co-pay if you are seen in the emergency room when it is not an emergency (If you are 17 or younger or if you are pregnant you will not be charged.)

Emergency or Urgent Care Outside of Your Service Area
Your service area is the county in which you live. If you travel outside your service area and you need medical care, Health Choice Utah will pay for emergency services only. You may use an urgent care facility in an emergency situation, if you are outside of your service area. Keep in mind, hospitals and urgent care centers outside of Utah must be willing to register with DWS and bill Health Choice Utah for the services.

All other medical care must wait until you return to your service area. In most cases, Health Choice Utah will not pay for prescriptions that you get outside the state of Utah. Health Choice Utah cannot cover or reimburse for any medical or health care services you get while outside the United States.