You do not need a referral or prior authorization for urgent or emergency services
— no matter where you travel:
- Prevea360 Health Plan covers urgent and emergency services while you are outside of our service area (subject to policy copays, coinsurance, deductibles and maximum allowable fees).
- Depending on the health care professional, the service could cost you more or not be paid for at all by your plan, which means you will be charged the full amount. Charging you this extra amount is called balance billing.
- If you require urgent or emergency care outside the service area and are unable to get to a plan provider, go to the nearest urgent care or emergency center for treatment. It is important to notify Prevea360 Health Plan as soon as possible by calling the Customer Care Center at 877-230-7555.
- All follow-up care should be done by a plan provider. If you are out of the area and unable to see a plan provider, call your primary care practitioner for a referral to an out-of-area provider. These services require approval by Prevea360 Health Plan.