For emergency care, call 911 or go to the nearest emergency room (ER).
For emergency care, you do not need pre-approval (prior authorization) from L.A. Care.
Inside the United States, including any U.S. Territories, you have the right to use any hospital or other setting for emergency care.
If you are outside the U.S., only emergency services requiring hospitalization in Canada and Mexico are covered. Emergency care and other care in other countries are not covered.
Emergency care is for life-threatening medical conditions.
This care is for an illness or injury that a prudent (reasonable) layperson (not a health care professional) with average knowledge of health and medicine could expect that, if you don’t get care right away, you would place your health (or your unborn baby’s health) in serious danger. This includes risking serious harm to your bodily functions, body organs or body parts.
Examples may include, but are not limited to:
- Active labor
- Broken bone
- Severe pain
- Chest pain
- Trouble breathing
- Severe burn
- Drug overdose
- Fainting
- Severe bleeding
- Psychiatric emergency conditions, such as severe depression or suicidal thoughts (may be covered by county mental health plans)
Do not go to the ER for routine care that is not needed right away.
You should get routine care from your PCP, who knows you best. If you are not sure if your medical condition is an emergency, call your PCP.
You can also call the L.A. Care Nurse Advice Line 24 hours a day, 7 days a week, including holidays at 1-800-249-3619 (TTY: 711).
If you need emergency care away from home, go to the nearest emergency room (ER), even if it is not in the L.A. Care network.
If you go to an ER, ask them to call L.A. Care. You or the hospital to which you were admitted should call L.A. Care within 24 hours after you get emergency care.
If you are traveling outside the U.S., other than to Canada or Mexico, and need emergency care, L.A. Care will not cover your care.
If you need emergency transportation, call 911. You do not need to ask your PCP or L.A. Care first before you go to the ER.
If you need care in an out-of-network hospital after your emergency (post-stabilization care), the hospital will call L.A. Care.
Remember: Do not call 911 unless it is an emergency.
Get emergency care only for an emergency, not for routine care or a minor illness like a cold or sore throat.
If it is an emergency, call 911 or go to the nearest emergency room.
L.A. Care Nurse Advice Line gives you free medical information and advice 24 hours a day, every day of the year. Call 1-800-249-3619 (TTY 711).