HPSM Medi-Cal

Emergency Care

Emergency care is for emergency medical conditions. It is for an illness or injury that a reasonable layperson (not a health care professional) with average knowledge of health and medicine could expect that, if you don’t get care right away, your health (or your unborn baby’s health) could be in danger, or a body function, body organ or body part could be seriously harmed.

Examples of emergencies

• Active labor
  
• Broken bone
  
• Severe pain, especially in the chest
  
• Severe burn
  
• Drug overdose
  
• Fainting
  
• Severe bleeding
  
• Psychiatric emergency condition
  

Do not go to the ER for routine care

You should get routine care from your PCP. If you are not sure if it is an emergency, call your PCP or the 24/7 Nurse Advice Line.

If you need emergency care away from home, go to the nearest emergency room, even if it is not in the HPSM network. If you go to an ER, ask them to call HPSM. You or the hospital to which you are admitted should call HPSM within 24 hours after you get  emergency care.

If you need emergency transportation, call 9-1-1. You do not need to ask your PCP or HPSM first before you go to the ER.

If you need care from an out-of-network hospital after your emergency (post-stabilization care), the hospital will call HPSM.

Follow-up Care

After receiving emergency health care services necessary to stabilize your emergency medical condition, be sure to follow up with your Primary Care Physician.

Call HPSM’s Nurse Advice Line

If you are worried about your health, HPSM has a Nurse Advice Line open 24 hours a day, 7 days a week. Call 1-833-846-8773 if your healthcare provider is not available.

Registered nurses are ready to answer questions about your symptoms. They can tell you:

• How soon to see a healthcare provider
• What to do if your symptoms get worse
• What you can do at home to start feeling better