Healthcare for Students Away from Home

Please Note: This information only applies to Care Choices HMO Members.

Care Choices can cover your child's health care needs while he or she is away at school and outside the Care Choices HMO service area. Please see the guidelines below for how your child can obtain care.

Coverage for Emergency Care
Coverage for Urgent Care
Coverage for Routine Care

Emergency Care

If your child is faced with an emergency condition away from home, your child should:

• Call 911 or go to the nearest hospital and show his or her Care Choices HMO Member ID Card.
• Ask the facility to send the bill to Care Choices HMO at the address listed on the back of the Care Choices HMO Member ID Card.
• Call his or her primary care physician within 48 hours of receiving emergency care. The doctor will then arrange any follow-up care with Care Choices participating providers.

Examples of emergency conditions are broken bones, convulsions, severe burns, and poisoning.

Please remember Care Choices will only cover emergency services follow-up care that is pre-authorized by your child's primary care physician. Also, Care Choices will only cover out of plan services when approved by Care Choices Medical Director.

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Urgent Care

If your child is faced with an urgent condition that is not an emergency while away at school, your child should:

• Call his or her primary care physician for instructions.
• The primary care physician will arrange for your child's medical care if needed and obtain approval for out-of- area care from a Care Choices HMO Medical Director.
• Hospital care and urgent care must be approved in advance by Care Choices HMO, except in the case of an emergency condition.

Examples of urgent medical conditions are minor sprains, minor cuts and minor burns.

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Routine Services

Most of the time, your child's primary care physician will be the one who provides his or her routine care. Your child's primary care physician must arrange the following services:

• Routine care
• Physician exams
• Diagnostic tests
• Urgent Care
• Follow up treatment after an emergency visit

For these services, Care Choices HMO offers students two options:

Option 1:
If your child is attending school in a Care Choices HMO service area, your child can choose a primary care physician in this area and have this physician arrange care.

Option 2:
If your child's school is outside our service area, he or she must return home to be covered for services. So plan to make appointments for physicals, preventive health care, and other routine care well in advance so they coincide with your child's vacation breaks.

If the physician decides your child needs specialty care, he or she will refer your child to a Care Choices HMO participating specialist and coordinate your child's care.

Care Choices HMO will only pay for care that is a covered benefit, arranged by your child's primary care physician and performed by a Care Choices provider. If urgent care is required outside of Care Choices service area, the primary care physician will obtain approval for out-of-area care from a Care Choices HMO Medical Director.

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