Emergency and Urgent Care
To know when to visit an emergency room, you need to
understand the difference between emergency care and
urgent care, especially since the Plan pays benefits for
emergency care only in the case of a true emergency, as
defined here:
Emergency Care
An emergency is a situation in which you have
an illness or injury that you believe is life
threatening or will cause you serious harm.
Examples of symptoms that may require emergency
care include uncontrollable bleeding and
chest pains.
If you experience symptoms that any reasonable
person would consider severe enough for
an emergency room visit, the Plan will cover
you. It does not matter if the emergency room
visit is In-Network or Out-of-Network. You or
someone who can speak on your behalf must
call the CIGNA/ComPsych care coordinator,
using the telephone numbers listed on your
CIGNA/ComPsych Member Services ID card
within two business days of the emergency
room visit.
In the case of a behavioral health emergency,
you must call the Member Assistance
Program (MAP) at the telephone number
listed on your ID card.
