HPSM Medi-Cal

Emergency Care

For emergency care, call 9-1-1 or go to the nearest emergency room (ER). You do not need pre-approval (prior authorization) for emergency care.

Emergency care is for emergency medical conditions. It is for an illness or injury that a 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, your health (or your unborn baby’s health) could be in danger, or a body function, body organ or body part could be seriously harmed.

Examples of emergencies

  • Active labor
  • Broken bone
  • Severe pain, especially in the chest
  • Severe burn
  • Drug overdose
  • Fainting
  • Severe bleeding
  • Psychiatric emergency condition

Do not go to the ER for routine care

You should get routine care from your PCP. If you are not sure if it is an emergency, call your PCP or the 24/7 Nurse Advice Line.

If you need emergency care away from home, go to the nearest emergency room, even if it is not in the HPSM network. If you go to an ER, ask them to call HPSM. You or the hospital to which you are admitted should call HPSM within 24 hours after you get  emergency care.

If you need emergency transportation, call 9-1-1. You do not need to ask your PCP or HPSM first before you go to the ER.

If you need care from an out-of-network hospital after your emergency (post-stabilization care), the hospital will call HPSM.

Remember: Do not call 9-1-1 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.

Follow-up Care

After receiving emergency health care services necessary to stabilize your emergency medical condition, be sure to follow up with your Primary Care Physician.

HPSM Nurse Advice Line

Call 1-833-846-8773 24 hours a day–7 days a week.

A Licensed Registered Nurse (RN) will give you medical advice when you think you need urgent medical attention, but you are not sure. A nurse will ask about your symptoms and tell you:

  • If you need to go to Urgent Care
  • If you can wait to see your doctor (within 24 hours, 3 days, or longer)
  • How to take care of your symptoms at home

Learn more about the Nurse Advice Line.