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Emergency and Urgent Situations

What to Do in an Emergency

An emergency is when someone has severe pain, illness or injury. It could result in danger to your child or you.

  • Call 911 right away if you have an emergency, or go to the nearest emergency room.
  • Emergency rooms are for emergencies. Call your doctor before going, unless your emergency is severe.
  • Call our 24-hour Nurse Advice Line at 1-866-799-5321 (TTY 1-800-955-8770). You will be connected to a nurse. Our nurses are available to help you 24 hours a day, 7 days a week. Have your CMS Health Plan Member ID handy. The nurse may direct you to other care or may help you over the phone.

To get emergency services, you can go to any hospital or other setting for emergency care, regardless of network status.

What to do in a Behavioral Health Emergency

If you feel like feel like your child is a danger to herself or himself or others, call 911 or go the nearest emergency room. You can also call our 24-Hour Behavioral Health Crisis Line at 1-888-491-5252.

Urgent Care

Urgent Care is needed when someone has an injury or illness that must be treated within 48 hours. It is usually not life threatening, yet it cannot wait for a routine doctor’s office visit. Urgent Care is not emergency care. You may be told to go to an urgent care center for help. Urgent care centers do not require a prior approval.

When your child needs urgent care, follow these steps:

  • Call your child’s doctor. If it is after hours and the doctor cannot be reached, call our 24-hour Nurse Advice Line at 1-866-799-5321 (TYY 1-800-955-8770).
  • You will be connected to a nurse. The nurse may direct you to other care, or may help you over the phone. Have your child's CMS Health Plan Member ID card number handy.
  • A nurse may tell you to take your child to see another doctor or go to the nearest hospital emergency room.
  • You may also use our Find A Provider tool to locate the closest Urgent Care center to you. Click CMS Health Plan, then  Find a Provider/Pharmacy.