An emergency is when you need care right away. You need emergency care because you have an injury or sudden illness. A prior authorization is not required for emergency services.
Here are some examples of emergencies:
- Broken bones
- Bleeding that does not stop
- Heart attacks
- Major burns
- Drug overdoses
What to do if you have an emergency
Call 911 if you have a serious health problem or accident. You can also go the nearest emergency room (ER). Tell the ER person who your PCP is. Call your PCP as soon as you can to let him/her know about your emergency.
Here are some examples of when you should not use the emergency room:
- Sore throats
- Cold or flu
- Back pain
- Tension headaches
Urgent care is when you must get treatment within eighteen (18) to twenty-four (24) hours. Check with your PCP first before you get urgent care. Your PCP should see you if the urgent need is during regular office hours. If they cannot see you, they will send you to an urgent care office or to the emergency room (ER). Call Member Services if there are problems getting in to see your PCP. We will try to help you be seen.
How to get services after hours
Call your PCP if you think you need urgent medical care. If you cannot reach your PCP or the practitioner/provider on-call, call the Molina Healthcare 24-Hour Nurse Advice Line. Call toll-free (844) 800-5155 for an English-speaking representative. Call toll-free (866) 648-3537 for a Spanish-speaking representative.
Information to take to the emergency room
It is important to take information about yourself to the emergency room. Make sure to bring your Healthy Connections Medicaid card and your Molina Healthcare ID card.
You should have information about:
- Medications you are taking (including over-the-counter medication)
- PCP or specialist names and telephone numbers
- Medical equipment provider (if you have one)
- Home care provider (if you have one)