Wellcare CalViva Health Dual Align (HMO D-SNP): Urgently Needed Services (Urgent Care)
This is not emergency care. This is care provided at an urgent care center or by an out-of-network provider because an in-network provider is unavailable.
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How To Receive
Details on how to apply
Visit an urgent care center, walk-in clinic, or make an appointment with the nearest, first-available provider to address the urgent medical need.
You may also contact the Nurse Advice Line at any time. A nursing professional is standing by with answers to your questions 24 hours a day, 7 days a week for assistance with health-related questions.
You can reach the Nurse Advice Line by contacting the Member Services at 1-833-236-2366 (TTY users should call 711) and asking to be transfered to the Nurse Advice Line
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Urgently needed services are provided to treat a nonemergency, unforeseen medical illness, injury, or condition that requires immediate medical care but, given the circumstances, may not be possible, or is unreasonable, to obtain services from in-network providers.
Examples of urgently needed services that the plan must cover out of network are:
Immediate care is needed on the weekend
The member is temporarily outside the service area of the plan
Services must be immediately needed and medically necessary. If it is unreasonable given the circumstances to immediately obtain medical care from an in-network provider then the plan will cover the urgently needed services from a provider out-of-network.
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