When a Visit to the Emergency Room is Necessary
Sometimes it’s obvious that a situation is an emergency. But sometimes it’s not. In the heat of the moment, when your health rests on your decision, how do you know what to do?
If you experience any of the following, call 911 or go to the Emergency Room (ER) immediately:
- breathing problems
- broken bones
- chest pain or stroke
- dizziness or weakness that doesn’t go away
- head injury with passing out, fainting, or confusion
- heart attack
- heart problems
- heavy bleeding
- high fever that doesn’t get better with medicine or is accompanied by a headache and stiff neck
- injury to neck or spine, mainly if there is a loss of feeling or inability to move
- seizures, especially lasting three to five minutes
- sudden or severe pain
- unusual or bad headache, particularly if it started suddenly
The symptoms above aren’t a complete list but offer some guidance. Additionally, you should consider the number of symptoms you have. Several individual symptoms that seem minor may be significant when they happen at the same time.
If a health issue arises and you aren’t sure if you need to go to the ER, call the 24/7 Nurseline for advice at
1-833-968-1770 anytime, day or night.
When Your ER Visit Leads You to See a Specialist
During your ER visit, the doctor treating you may decide you need to see a specialist. You may need to see the specialist during your ER visit, after being admitted to the hospital, or when you are discharged.
For TRS-ActiveCare Primary and TRS-ActiveCare Primary+ participants,
you need a referral when seeing a specialist. When seeking emergency services, it will not be the same.
If you need a specialist while you’re in the ER, the specialist on duty at the time will likely see you. In this case, you don’t need a referral, and your health plan will cover your treatment without one.
If you’re admitted after your ER visit, the doctor treating you may recommend a specialist see you during your hospital stay. In that case, you also don’t need a referral.
However, you
will need a referral if you’re released from the ER or the hospital with a recommendation to follow up with a specialist.
You may want to try and continue to see the specialist the hospital assigned you or find someone new. You can get the necessary referral by contacting your Primary Care Physician (PCP).
Your PCP:
- knows your health history, your medications, and your lifestyle
- can help decide if you need any tests or if they agree you should see a specialist
- can serve as your health coach to show you better ways to stay healthier
You also have Personal Health Guides (PHGs) available to help you with your health care-related questions. They can ensure that, should you need a referral, the specialist recommended is in-network. That way, you can avoid the potential additional costs that you might incur if you see an out-of-network provider.
