Aetna members who need emergency care are covered 24 hours a day, 7 days a week, anywhere in the world. An emergency medical condition is “one manifesting itself by acute symptoms of sufficient severity such that a prudent layperson, who possesses average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in serious jeopardy to the person’s health, or with respect to a pregnant woman, the health of the woman and her unborn child.” In or out of Aetna service areas, members should follow the guidelines below when they need emergency care.

• Call the local emergency hotline (e.g., 911) or go to the nearest emergency facility. If a delay would not be detrimental to his or her health, the member should call his or her PCP first. If not, the member should notify his or her PCP as soon as possible after receiving treatment.

• After assessing and stabilizing the member’s condition, the emergency facility should contact the member’s PCP to assist the treating physician by supplying information about medical history and authorizing any follow-up care. Please advise your employees to review their plan documents to determine any time limits for notification.

• If a member is admitted to an inpatient facility, the member, a family member or friend should notify the member’s PCP on his or her behalf as soon as possible.
• All follow-up care should be coordinated by the PCP.