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Choose the care option that’s right for you.
Being an Ambetter member means getting the care you need, when you need it. But every situation is different. Are you sick? Injured? Do you need a checkup? Be prepared for any medical situation by taking a look at the care options available to you:
Your Primary Care Provider (PCP)
Your primary care provider is your main doctor — the one you see for regular checkups. If your condition isn’t life-threatening, calling your PCP should be your first choice. Use our online Find a Provider tool to find an in-network provider in your area.
Visit or call your PCP if you need:
- Your annual wellness checkup & vaccinations
- Advice about your overall health
- Help with medical problems such as cold, the flu and fevers
- Treatments for an ongoing health issue like asthma or diabetes
Ambetter Telehealth — NEW in 2019!
Telehealth offers convenient, 24-hour access to in-network healthcare providers for non-emergency health issues. You can get medical advice, a diagnosis or a prescription by phone or video. Use Telehealth anytime or schedule an appointment wherever and whenever you need it. Set up your Ambetter Telehealth account at AmbetterTelehealthPA.com.
Contact Telehealth for illnesses such as:
- Sinus problems and allergies
- Upper respiratory infections
- Cold, the flu and fevers
- Rash and skin problems
24/7 Nurse Advice Line
Talk to a registered nurse any time of the day or night with this free service. The 24/7 Nurse Advice Line provides quick, reliable advice for medical situations that aren’t life-threatening. Call the Nurse Advice Line any time at 1-833-510-4727 (Relay 711).
Call the 24/7 Nurse Advice Line if you need:
- Help caring for a sick child
- Answers to questions about your health
- To determine whether you should see a doctor immediately
If you can’t wait for an appointment to see your PCP, an urgent care center offers fast, hands-on care for health conditions or injuries that require immediate attention. Be sure to visit an in-network urgent care center to avoid paying out-of-pocket costs.* Use our online Find a Provider tool to find an in-network urgent care facility in your area.
Use urgent care for medical issues such as:
- Ear infections
- High fevers
- Flu symptoms with vomiting
- X-rays and stitches
*Always refer to your Schedule of Benefits to make sure you understand the costs you may be responsible for if you choose a provider or service outside of our network.
Emergency Room (ER)
Go to the emergency room or call 911 if your condition is life-threatening. If you have a serious accident or illness, the ER may save your life. But if your situation isn’t life-threatening, you may receive more prompt care through one of the other options available to you. Plus, visiting the ER may increase your out-of-pocket costs significantly.
CALL 911 or get to an ER if you experience:
- Shortness of breath, asthma
- Chest pains
- Bleeding that won’t stop
- Severe cuts or burns
What’s the difference between in-network and out-of-network?
In-Network means the doctor, pharmacy or facility is included in the Ambetter network. You should always try to use in-network services and providers.
Out-of-Network means the doctor, pharmacy or facility is not included in the Ambetter network — and isn’t covered by your health plan. You’ll likely pay more for those out-of-network services and providers.
Always have your member ID card with you when you receive medical care.