Use of an urgent care provider is limited to after-hour services, weekends or holidays. No PCP referral is needed to see an urgent care provider. Contact your PCP by phone within 2 days or the first business day, whichever is later. If you are required to pay for urgent care services immediately, contact the Member Services Department to request a subscriber claim form. Copayments apply for urgent conditions.
Coverage applies to visit with doctor, physician's assistance, nurse practitioner or nurse midwife.
Copayments or coinsurance may vary according to the type and time of the visit. For example, there may be a higher copayment for after-hours care. Prescribed x-ray, laboratory and other diagnostic medical procedures. Screening mammograms available without referral . Prior approval is required for some services, such as MRIs.