Emergency Care
OHP covers emergency care. You do not need approval before you get care in a true emergency. However, if is not a true emergency, you may have to pay the bill.
Emergencies are sudden illnesses or injuries that need treatment right away. Not being treated right away could cause severe problems or death.
- Examples of a medical emergency are appendicitis, severe pain that won't go away with home treatment, broken bones, heart attack, bleeding that won't stop, stroke or concussion.
- Examples of a dental emergency are an adult tooth that falls out, severe tooth pain or serious infection.
- Examples of a behavioral health emergency are feeling out of control or thinking about hurting yourself or others.
If you are pregnant, OHP also covers your unborn baby for true emergency care.
Go to an emergency room or call 911. Do not wait because you don’t have your ID cards.
- Tell the emergency room staff you are an OHP member.
- If you are in a CCO, tell them your CCO’s name.
- Also tell them about any other health coverage you have.
The emergency room staff will call your doctor if they need to know more about you.
Call 911 for an ambulance. However, if you use an ambulance and it is not a true emergency, you may have to pay the bill.
Urgent Care
Urgent care means that you need care soon, but do not need to go to an emergency room. You do not need an appointment to go to urgent care.
You can use urgent care when it's not an emergency, but you can't wait for an appointment with your primary care provider. Reasons to use urgent care could be:
- Burns
- Sprains
- Ear infections
Follow these steps. If you need an interpreter, please let the clinic know.
- Call your doctor or dentist.
- If you can't reach your doctor or dentist, call your CCO or dental plan.
- If you aren't in a CCO, call OHP's advice line at 800-562-4620 (TTY 711). Nurses are there all day and night, every day of the year. A nurse can help you decide where to go. The nurse may tell you to go to an urgent care center or wait to see your regular doctor or dentist.
Getting Follow-up Care
Call your doctor or dentist as soon as possible after you get urgent or emergency care.
- Tell them where you were treated and why.
- Your doctor or dentist will manage your follow-up care and schedule an appointment if you need one.
Care you get after the emergency is over is not an emergency. If you are out of state and need follow-up care, call your CCO or OHP Client Services. They will tell you what you need to do.