Emergency, Urgent and Follow-Up Care

What are Emergency Services?   |   What is Urgent Care?   |   What is Follow-Up Care?
Urgent Care and Follow-Up Care Outside Keystone’s Service Area —
The BlueCard® Program’s Urgent and Follow-Up Care Benefits

What is Urgent Care?

“Urgent Care” is medically necessary covered services provided in order to treat an unexpected illness or accidental injury that does not require emergency services. Urgent care covered services are required in order to prevent a serious deterioration in the member’s health if treatment were delayed.

Examples of conditions requiring urgent care are:

• severe vomiting;
• severe eye pain with redness; and
• severe ear pain.

Urgent Care Inside Keystone’s Service Area
You are in the service area if you are in Bucks, Chester, Delaware, Montgomery or Philadelphia county.

• If you are within the service area and your child needs urgent care, call his or her primary care physician first.
• If your child’s primary care physician is not in the office, leave a message requesting a return call.
• Your child’s primary care physician provides coverage 24 hours a day, 7 days a week for urgent care.
• Your child’s primary care physician, or the physician covering for your child’s primary care physician, will arrange for appropriate medically necessary treatment.

	NOTE: You must call your child’s primary care physician to arrange for urgent care treatment. Urgent care services will be covered only when provided or referred by your child’s primary care physician.