Getting emergency care with a Medicare Advantage (MAPD) or Medigap plan

A medical emergency is a medical problem, illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.

Wherever you are, get help immediately

Call 911 for help or go to the nearest emergency room or hospital. Call for an ambulance if you need it. You do not need to get approval or a referral first from your PCP.

Then call Priority Health

As soon as possible, let us know about your emergency. We need to follow up on your emergency care. You or someone else should call to tell us about your emergency care, usually within 48 hours. You can find our phone number on the back of your membership card.

What is covered if you have a medical emergency?

You can receive covered emergency medical care whenever you need it, anywhere in the United States or worldwide emergency/urgent coverage.

  • Emergency or urgent care is always considered "in network."
  • Emergency or urgent care, post-stabilization care, or dialysis that you receive outside our network will be considered in-network.

Our Medicare Advantage plans also cover ambulance services in situations where getting to the emergency room in any other way could endanger your health.

Some examples of emergencies

  • Injury to eyes or ears
  • Trouble breathing after taking medication or being bitten by an insect
  • A broken bone
  • Chest or upper stomach pain
  • Coughing up or throwing up blood
  • Pain in the chest and one arm
  • Bleeding that won't stop
  • Poisoning or drug overdose
  • Seizure
  • Sudden dizziness or weakness
  • Slurred speech
  • Sudden difficulty seeing