We’ve Got You Covered
Posted on June 8, 2010
Linda Hughes, Member Services Representative
What happens if I need urgent or emergency medical care while traveling?
As the summer months approach, many of you may be thinking about summer vacations. I thought it would be a good idea to remind you what to do if you are outside of the HNE service area and need medical care.
If you are sick or you get hurt and can’t safely travel back to your service area to see an in-plan provider, you should seek treatment at the nearest emergency room, urgent care center, or doctor’s office. If you have time, call your primary care provider (PCP) first and clearly state your symptoms. Follow your doctor’s orders and seek the recommended treatment. If you are unable to call or reach your PCP, go to the nearest emergency room. If it is a true emergency, dial 911. Remember that if you have a Health Maintenance Organization (HMO) policy and are seen at a facility other than an emergency room, such as an urgent care center or doctor’s office, you must call HNE to report the visit at your earliest convenience. Unless you are out of the country, all follow-up care must be coordinated through your PCP. Once you have received initial treatment in the emergency room, urgent care clinic, or doctor’s office, you must contact your PCP. Your doctor will work with you to coordinate an authorization with HNE if it is determined that you will need additional services outside the HNE service area.
What happens if I need a prescription while I am traveling?
For those of you whose prescription coverage is through Health New England, we have a national pharmacy network. We should have a contracted pharmacy near where you are in the United States. You can find the locations of our pharmacies by calling our Member Services team at 800.310.2835. TTY/TDD users should call 800.439.2370. If you are outside of the country and need medication due to an emergency, you must pay for the prescription and submit your receipt for reimbursement, less your applicable copay, when you return.
We hope this information is helpful in planning your summer travel. If you have any further questions, please don’t hesitate to call a member of our Member Services team. We are here to help, and are happy to do so.
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