When you are sick

When you are sick, it is important for you to know what to do. Here is information on the services available if you become sick.

Your primary care provider (PCP)

Always try to call your PCP when you feel sick. If your problem is not an emergency, the PCP can arrange for you to come into the office for care. Your PCP is available to you 24 hours a day, 7 days a week.
If you get sick after your PCP’s office is closed, call the office anyway. Someone will answer, and the PCP will call you back. If you cannot reach your PCP, call the Nurse Call Line at 1-800-304-5436.

Nurse Call Line

Our Nurse Call Line is a confidential service you can call 24 hours a day, 7 days a week at 1-800-304-5436. This is a free service with specially trained nurses. The nurses listen to your symptoms and help you make a good health care decision when your doctor is not available. They can help you decide the kind of care you need based on your symptoms. Please remember that the Nurse Call Line does not take the place of your doctor. Always talk with your doctor if you have questions about your health care.

Urgent care centers

Urgent care is for conditions that are serious, but not emergencies. This is when you need attention from a doctor, but not in the emergency room (ER). Some examples are:

  • Sore throat.
  • Flu or cold.
  • Earaches.
  • Vomiting or diarrhea.
  • Pink eye.
  • Rashes.
  • Animal bites.

If you need urgent care, but you are not sure it is an emergency, call your PCP first. He or she will help you decide if you need to go to the ER, the PCP's office, or a nearby urgent care center. If you cannot get in touch with your PCP, the 24-hour Nurse Call Line is always available to you. If you do go to an urgent care center, please be sure to call your PCP for a follow-up visit within 24 hours.

To find an urgent center near you, check out our online provider directory.

Emergency rooms

An emergency is when you must be seen by a doctor right away. Dial 911 for an ambulance or go straight to the nearest ER. Some examples of an emergency are:

  • Chest pain.
  • Choking.
  • Poisoning.
  • Severe wound or heavy bleeding.
  • Trouble breathing.
  • Broken bones.
  • Any serious accident.

These are just some examples of an emergency.

You do not need approval from First Choice to get care in an emergency. The hospital cannot turn you away. It is the law. If you do go to the ER, call your PCP for a follow-up visit within 24 hours.

After you’ve been to the hospital

Once you return home from the hospital or emergency room, you need follow-up care to help with your recovery. The combined services and care that a member needs after discharge from the emergency room or a hospital stay are called post-stabilization services. This would include things such as:

  • A follow-up appointment with your PCP or admitting health care provider.
  • Filling your prescriptions related to the ER or hospital admission.
  • Taking those medicines as directed by the prescribing health care provider.
  • Getting any needed home health services and durable medical equipment.
  • Member education about benefits and services.

The Rapid Response and Outreach Team or an assigned Care Manager can help members with post-stabilization services and coordinate hospital discharge needs.

If you have more questions or cannot find what you are looking for on our website, please call Member Services at 1-888-276-2020. Or, take a look at our member handbook (PDF).