Emergency Care

When you have a true emergency call 9-1-1 to get immediate medical care.

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. You can also call the Nurse Advice Line at 1-855-458-0622. The Nurse Advice Line is available 24 hours a day, 7 days a week.

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 BCBSAZ Health Choice provider network.

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, BCBSAZ Health Choice 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 Arizona must be willing to register with DWS and bill BCBSAZ Health Choice for the services.

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