i lost my medical card and need to go to hospital

What conditions generally do not require Emergency Department treatment?.Some examples of situations that would require the use of an Emergency Department include but are not limited to: Also, note that in each of these situations care may be reviewed retrospectively to make sure it met the criteria for coverage of emergency/urgent care treatment.Īn emergency is the sudden onset of a medical condition with such severe symptoms or pain that a person with an average knowledge of health and medicine (prudent layperson) would seek medical care immediately because there may be serious risk to your physical health, your mental health, or that of your unborn child. This enables Optima Health to arrange for appropriate follow-up care, if necessary. If you received emergency care and are admitted, you or a family member should contact Optima Health within 48 hours (two business days) or as soon as medically possible. In any life-threatening emergency situation, always go to the closest emergency department or call 911. What should I do if I have an emergency?.However, since they are unable to access medical records, they cannot diagnose or medically treat conditions, order labs, write prescriptions, order home health services, or initiate hospital admissions or discharges. The staff are well-prepared to answer medical or behavioral health questions for members and their dependents. The 24/7 Nurse Advice Line nurses have training in emergency medicine, acute care, OB/GYN, and pediatric care. If necessary, the nurse may direct you to a Plan urgent care center or Emergency Department.

Be sure to mention any other medical conditions that you have, such as diabetes or hypertension.ĭepending on the situation, you may be advised about appropriate home treatments or advised that a visit to your Plan doctor will take care of it. What happens when I call the 24/7 Nurse Advice Line?Ī registered nurse will ask you to describe your medical situation in as much detail as possible.If you have an illness, injury, or condition that occurs during an evening or weekend, you should call your PCP or Plan doctor’s office or the 24/7 Nurse Advice Line number located on your member ID card. What should I do if I get sick or hurt after business hours or during the weekend?.Remember, in an emergency always call 911 or go to the nearest emergency department. Once ordered, the card should arrive in seven (7) to ten (10) business days.Ĭall the number on the back of your member ID card. Always show your member ID card to your doctor when you receive a new one. Unless you ordered a new card online or through member services the only reason you will receive a new card is if important information on it has changed. I received a new member ID card in the mail but I already have one.In addition, it provides information such as copay amounts, applicable deductibles, your member ID number, and important phone numbers and addresses. Your member ID card identifies you as a covered member of Optima Health. Why do I need to carry my member ID card?.If your doctor requires you to present a card at the time of service, member services will fax a sample of your card to their office. This number allows a doctor to verify your eligibility and bill your services to the health plan. If your application has been processed they will be able to give you your unique member ID number. What should I do?Ĭontact member services. I have not received my member ID card but need to see my doctor.If you still have questions, contact member services. Refer to this section of the website for answers to commonly asked questions. When and where do I call if I have questions?.Whether you go to school, are self-employed or between jobs, are ready to retire, have a family, or don’t have a health plan through work, Optima Health has medical coverage that meets your unique needs. Individual Plans are offered for people who do not have coverage through their employer. It is best to check with your employer to see if a health plan by Optima Health is an option for you. Optima Health offers a HMO for Virginia Medicaid and FAMIS beneficiaries called Optima Family Care. These products include: Optima Vantage, Optima Plus, Optima Equity, and Optima Design. Optima Health offers many products for large and small group employers, such as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Consumer Directed Health plans.

I lost my medical card and need to go to hospital