When dealing with immediate and serious physical health or behavioral health concerns, the top priority is getting the most effective care as quickly as possible. See below suggestions for types of care for specific injuries and illnesses.

Life threatening symptoms/situations – Emergency Room or 911 call   

Examples:

• Significant trauma or injury, especially to the head or neck
• Chest pain
• Bleeding that won’t stop
• Shortness of breath
• Broken bones
• Poisoning
• Severe cuts or burns
• Severe lower abdominal pain
• Severe allergic reaction
• Symptoms of sepsis (sudden confusion or high fever not improving with medicine)

Physical injury or an illness like the flu, ear infection, or a fever

• Call your child’s pediatrician. Many have after-hours options and can give advice until you can be seen.
• Go to an in-network urgent care center.
• Utilize your health plan’s Telehealth options.
• Call your health plan. Most health plans have after-hours Nurse Advice Lines for answers to health questions, learning where to go for care, and help finding in-network providers.

Behavioral health crisis

• Most health plans have a 24-hour Behavioral Health Crisis Line
• 988 Suicide & Crisis Lifeline (text or call)
• NAMI Teen & Young Adult Helpline (text “Friend” to 62640, chat at nami.org/talkouts or call 1-800-950-6264 Monday – Friday 10am to 10 pm ET)

For Sunshine Pathway to Shine members, click here for more health plan information, including your telehealth options and the Find a Provider Tool.

For members on other Medicaid plans, click here.