Mental Health and Substance Use Services for Adult Members

What is an emergency medical condition?

Emergency medical condition means a medical condition manifesting itself by acute symptoms of recent onset and sufficient severity (including severe pain), such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical care could result in: 

  • Placing the patient’s health in serious jeopardy; 
  • Serious impairment of bodily functions; 
  • Serious dysfunction of any bodily organ or part; 
  • Serious disfigurement; or 
  • In the case of a pregnant women, serious jeopardy to the health of a woman and her unborn child. 

 Emergency care is available 24 hours a day, 7 days a week. 

 You and/or your child have an EMERGENCY medical need if: 

  • You think you and/or your child’s condition is life-threatening; 
  • You and/or your child has serious pain; or 
  • Serious harm could come to you and/or your child if you do not get immediate medical care. 
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