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Emergencies and Urgent Care

If you believe you have an emergency, call 911 or go to the nearest emergency department.

  • You do not need approval from your plan or your PCP before getting emergency care, and you are not required to use our hospitals or providers.
  • If you're not sure, call your PCP at any time, day or night. Tell the person you speak with what is happening. Your PCP's team will:
    • Tell you what to do at home
    • Tell you to come to the PCP's office
    • Tell you to go to the nearest urgent care or emergency department
  • If you are out of the area when you have an emergency:
    • Go to the nearest emergency department.

Remember: Use the emergency department only if you have an emergency. If you have questions, call your PCP or AmeriHealth Caritas North Carolina Member Services at 1-855-375-8811 (TTY 1-866-209-6421).

Emergencies

You are always covered for medically necessary emergencies. An emergency medical condition is a situation in which your life could be threatened, or you could be hurt permanently if you don’t get care right away. Some examples of an emergency are:

  • A heart attack or severe chest pain
  • Bleeding that won’t stop or a bad burn
  • Broken bones
  • Trouble breathing, convulsions or loss of consciousness
  • When you feel you might hurt yourself or others
  • If you are pregnant and have signs like pain, bleeding, fever or vomiting
  • Drug overdose

Some examples of non-emergencies are colds, upset stomach or minor cuts and bruises. Non-emergencies may also be family issues or a break up. 

Urgent care

You may have an injury or an illness that is not an emergency but still needs prompt care and attention. This could be:

  • A child with an earache who wakes up in the middle of the night and won't stop crying
  • The flu
  • A cut that needs stitches
  • A sprained ankle
  • A bad splinter you cannot remove

You can walk into an urgent care clinic to get care the same day or make an appointment for the next day. Whether you are at home or away, call your primary care provider (PCP) any time, day or night. If you cannot reach your PCP, call the 24/7 Nurse Line at 1-888-674-8710. Tell the person who answers what is happening. They will help you find care.

Tell the person who answers what is happening. They will tell you what to do.

Whether you are at home or away, you can walk into an urgent care clinic to get care the same day or make an appointment for the next day. If you would like assistance making an appointment:

  • Call your PCP any time day or night.

If you are unable to reach your PCP, call Member Services at 1-855-375-8811 (TTY 1-866-209-6421).