What is the Difference Between a Medical Emergency and Urgently Needed Care?
The two main differences between urgently needed care and a medical emergency are in the danger to your health and your location. A “medical emergency” occurs when you reasonably believe that your health is in serious danger, whether you are in or outside of the service area. “Urgently needed care” is when you need medical help for an unforeseen illness, injury, or condition but your health is not in serious danger and you are generally outside of the service area. Under unusual and extraordinary circumstances, care may be considered urgently needed and paid for by The Health Plan/THP when you are in the service area, but the provider network is temporarily unavailable or inaccessible.
