What are Emergency Services and Care?
Emergency Services and Care means a medical screening physical examination, and evaluation by a doctor, or by other medical staff who work under the direction of a doctor.  The doctor must decide if the problem really is an emergency medical condition.  If the problem really is an emergency medical condition, emergency services and care is the care treatment, or surgery for the covered medical service needed to control or eliminate the emergency medical condition.  The treatment and care is done in a hospital setting.

Emergency Care in Miami-Dade or Broward County...
If you are at risk of damage to your health, go to the nearest emergency room
or call 911.

Emergency Care Out of Area...
The rules are the same for emergency medical care wherever you are when you need the care.

How to Get Care when it is NOT an Emergency or When Your Doctor's Office is Closed...
If you need medical care for minor illnesses and injuries, and it is not an emergency, call your primary care doctor; however, if you are calling after hours and cannot be seen by your doctor, call the providers listed below.  Be sure to call first, as hours and days of operation may vary.

Reporting Emergency Care to Preferred Medical Plan...
If you get emergency services and care, you should call Preferred Medical Plan as soon as possible after you first get the services to tell us where you are getting the medical care.  This way, your primary care doctor can plan for any other medical care you may need.  If you cannot call Preferred Medical Plan within 24 hours, have someone from the hospital staff, or a family member call Preferred Medical Plan, when it is possible.

What if I get Emergency Services and Care in an emergency room when it is NOT an emergency?
If you go to an emergency room and get treatment when it is not an emergency, you may have to pay the cost.  Preferred Medical Plan does pay for the medical care and services you get in the emergency room.  If it is decided after your exam and testing that your condition is not a medical emergency, Preferred Medical Plan will not pay for further medical care and services you may receive after this decision.  Preferred Medical Plan will not pay the medical bill, if you decide to be treated at the hospital, after it has been decided that your condition is not an emergency.  You must pay the medical bills.