You also do not need a referral for maternity care or for evaluating and treating sudden or emergency GYN conditions. If you receive care for an emergency, you or someone acting on your behalf should notify your PCP within 48 hours of the onset of the emergency, even if you are not admitted to the hospital. Always call your PCP to receive coverage and for direction on any follow-up care. There is a copayment for emergency room treatment. You are covered for urgent and emergency care services that you may receive when traveling.
Emergency care is defined above.
If you seek urgent or emergency care while traveling, you or someone acting on your behalf should notify your PCP within 48 hours after the onset of the urgent condition. Your PCP will provide or arrange for any routine or follow-up care. While Tufts Health Plan seeks to ensure the continued availability of network providers, providers may sometimes leave the network. This can be due to many reasons, including retirement, moving out of the area, or failure to reach agreement regarding the contractual relationship with Tufts Health Plan. Tufts Health Plan arranges for the provision of health care services by contracting with physicians and other providers practicing in their private offices throughout the service area.