What is a medical emergency?
An emergency medical condition is a medical or psychiatric condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in any of the following:
- serious jeopardy to your health
- serious impairment in your bodily functions
- serious dysfunction of any bodily organ or part
Examples of symptoms that may be an emergency medical condition include the following:
- chest pain or pressure which may radiate to the arms, neck, back, shoulder, jaw, arm, or wrist
- sudden onset of severe abdominal pain
- severe shortness of breath
- sudden decrease in or loss of consciousness
- sudden inability to talk or to move one side of the body, or sudden slurred speech
- severe, persistent bleeding that cannot be stopped
- major injuries such as gunshot or stab wounds or severe injuries from a vehicle accident
- for pregnant women only: "active labor," which means a labor when there is inadequate time for a safe transfer to a Plan hospital (or designated hospital) before delivery or if a transfer poses a threat to the health of the member or unborn child