Most managed care plans will pay for emergency room care in a true emergency. Managed care plans will not pay for follow-up care done in the emergency room. Find out which hospitals participate in your plan so you are prepared for an emergency. In a life-threatening emergency, go to the nearest hospital. Most plans will pay for after-hours emergency room care at a hospital that is not in your plan only if it is a true emergency.
Plans vary on how they provide after-hours care.
Check ahead of time with your pediatrician or managed care plan. If your child is sick or injured, you should call your pediatrician or the person on call for advice. Someone will talk to you about the problem and may give you advice over the phone, see your child, or refer you and your child to an after-hours facility. Work with your pediatrician to choose a hospital in your plan that specializes in the care of children. If your plan does not include one, talk to your pediatrician about what arrangements will be made if and when your child requires care at a hospital that does specialize in children.