Emergency Coverage

In a medical emergency, you must call your primary care physician (PCP) before using hospital emergency room service, except when you are in a life-threatening situation or you are outside the service area when emergency care is required. A life-threatening illness or injury is one that requires immediate medical or surgical treatment to prevent death or permanent disability. Examples of life-threatening emergencies include unusual or excessive bleeding, broken bones, acute abdominal pain, acute chest pain, suspected heart attack, burns, poisoning, unconsciousness, convulsions, or choking.

Within the Enrollment Area

You will receive full coverage after a $40 copayment per person per visit for hospital emergency room treatment you receive in the Boston Medical Center Preferred Inner Circle. This copayment will be waived, however, if you are immediately admitted to the hospital.

Outside the Enrollment Area

When you are temporarily outside the enrollment area, Boston Medical Center Preferred will cover emergency room treatment in full after a $40 copayment per person per visit if the illness or injury is sudden and life-threatening. This copayment will be waived, however, if you are immediately admitted to the hospital.