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Emergencies and Urgent Care

AmeriHealth Caritas Iowa wants to be sure our members get the care they need for emergency and urgent problems.

If you need care, but are not sure if it is an emergency, call your PCP first. If you can't reach your PCP, call the AmeriHealth Caritas Iowa 24/7 Nurse Call Line at 1-855-216-6065. Your PCP or the nurse will help you find the best care.

If you're an Iowa Health and Wellness or hawk-i member and you get care in the emergency room for a condition that is not considered an emergency, you will be charged a copay. The copay is $8 for Health and Wellness members and $25 for hawk-i members. hawk-i members with incomes less than 150 percent of the federal poverty level will be exempt from the copay.

If you go to an urgent-care center or the emergency room (ER), be sure to call your PCP the next day. Make an appointment. Your PCP should see you within 2 calendar days of your request for an urgent-care visit.

Urgent care

Urgent care is for problems that are serious. These problems are not emergencies. This is when you need to see a doctor right away, but not in the ER.

Examples of urgent care conditions are:

  • Coughing.
  • Colds.
  • Vomiting.
  • Pink eye.
  • Diarrhea.
  • Stomachache.
  • Earache.
  • Rashes.
  • Sore throat.
  • Lacerations.
  • Toothache.

You can go to urgent care centers without making an appointment. To find an urgent care center near you, use Find a doctor.

Emergencies

If you have an emergency, call 911 or go to the ER.
You should only go to the ER when you need care right away for a severe injury or illness. Emergency services are available 24 hours a day, 7 days a week.

An emergency is a serious or life-threatening condition that:

  • Needs medical care right now.
  • Puts your health at risk.
  • Causes serious harm to your body.

Examples of emergencies are:

  • Chest pain.
  • Choking.
  • Severe wound or heavy bleeding.
  • Being unable to breathe properly.
  • Severe spasms/ convulsions.
  • Loss of speech.
  • Broken bones.
  • Severe burns.
  • Drug overdose.
  • Sudden loss of feeling or not being able to move.
  • Severe dizzy spells, fainting or blackout.

You do not need approval from AmeriHealth Caritas Iowa to get care in an emergency. You have the right to get the care you need. You also have the right to say no to treatment. You can ask for, or say no to, a transfer to a hospital.

You don't have to pay for emergency care. If one of our staff members tells you to get emergency care, you still don’t have to pay.

Call your PCP to set up a visit for care after your emergency. Do not go back to the ER where you were treated unless your PCP tells you to.