What if I go to an out-of-network hospital in a true medical emergency?
In a true medical emergency, you should seek immediate treatment by going to the nearest Emergency Room (ER), or calling 911 or your local emergency response number. Based on current federal and state laws, if you go to an out-of-network ER within the United States for a true medical emergency, the services will process and pay as in network or the equivalent in-network tier (e.g., OMNIA Tier 1), depending on your benefits. That means the most you would owe is any copay, deductible or coinsurance that you would owe for the same service if it were in network or, if you are an OMNIA Health Plan member, if it were OMNIA Tier 1.
Benefits for medical care outside of the United States will vary based on your plan. Use our Email Us or Chat tools for questions about international coverage.
To view your specific costs for ER services in the United States:
- Click Benefits Overview under Benefits & Coverage.
- On the Medical tab, scroll down to Plan Details.
- View the information for Emergency Room Visits to see the amount you would owe for an ER visit. This will also show if you have to meet your deductible in addition to paying a copay for an ER visit. The deductible is the amount you must pay before your plan starts to pay for certain covered services, and is also listed on this page.
For most but not all members, the amount you would owe for an ER visit may be listed on the front of your medical member ID card. And, for some members, this amount may only apply after you meet your deductible. View your coverage information online for more specific cost information.
If you think you’ve been billed incorrectly for emergency medical services, use our Email Us or Chat tools to contact us, call the No Surprises Help Desk at 1-800-985-3059, or visit cms.gov to submit a complaint online.
Learn more about state and federal laws against surprise medical bills.
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