What is an emergency?

An emergency is when you have severe pain, illness or injury. It could result in danger to you or your unborn child. Call 911 right away if you have an emergency. Or go to the nearest emergency room. You do not need a doctor’s approval to get emergency care. If you are not sure if it is an emergency, call your PCP. Your PCP will tell you what to do. If your PCP is not available, a doctor taking calls can help. There may be a message telling you what to do.

Go to the nearest hospital emergency room. It is all right if the hospital does not belong to the Sunshine State network. Just call us as soon as you can. We will help you get follow-up care. Call Sunshine State at (866) 796-0530.

Emergency rooms are for emergencies. Call your doctor before going unless your emergency is severe. You can call our 24-hour emergency number at (866) 796-0530. Press option 7. Sunshine State members can use any hospital for emergency services.

Be sure to get care after your emergency.

What is Urgent Care?

Urgent Care is needed when you have an injury or illness that must be treated within 24 hours. It is usually not life threatening, yet you can’t wait for a routine doctor’s office visit. Urgent Care is not emergency care. Only go to the emergency room if your doctor tells you to go. When you need urgent care, follow these steps:

1. Call your PCP. The name and phone number are on your Sunshine State ID card. An after hours number may also be listed. You may be given directions over the phone.
2. If it is after hours and you cannot reach your PCP, call NurseWise at (866) 796-0530. Press option 7. You will be connected to a nurse. Have your Sunshine State ID card number handy. The nurse may direct you to other care. Or the nurse may help you over the phone. You may have to give the nurse your phone number. During normal office hours, the nurse will assist you in contacting your PCP.If you are told to see another doctor or go to the nearest hospital emergency room, do this:
   • Bring your Sunshine State ID card and your Medicaid card.
   • Ask the doctor or hospital to call your PCP or Sunshine State as soon as possible.