Emergency care
If you have an immediate and unforeseen emergency and taking the time to call your primary care physician may mean permanent damage to your health, seek treatment first. Go to the nearest emergency room, or call 911. An immediate and unforeseen emergency refers to any condition that causes symptoms severe enough that someone with average health knowledge would believe that immediate medical attention is needed.
We cover emergency care for two types of problems:
- Accidental injuries:
These are traumatic injuries which, if not immediately diagnosed and treated, could be expected to result in permanent damage to your health. The injury usually comes from external sources and requires prompt medical attention such as broken bones, sprains, severe cuts, poisoning and burns. - Medical emergencies:
These are the sudden onset of a medical condition that shows signs and symptoms of sufficient severity, including severe pain, so that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to your health. In the case of a pregnant woman, it would be reasonable to expect that the emergency could jeopardize the pregnancy.
After the emergency has passed, your PCP can arrange appropriate follow-up care. Tell your doctor about your emergency within 24 hours or when it is medically reasonable to do so. If you cannot make the call, ask the hospital or someone acting for you to make the call.
Most hospitals bill us directly for emergency services provided to our members. If you happen to receive a bill, send it to us with an explanation of the service and your paid receipt. Use the Member Reimbursement form (95K PDF). Be sure to include:
- An itemized bill
- Original proof of payment
- The treatment record or emergency report
- The name and dosage of any prescription drug, as well as the original prescription receipt
Send to:
Blue Care Network
P.O. Box 68767
Grand Rapids, MI 49516-8767
page modified 09/23/2011