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17
Where to Go for Care Guide
Visit Type
Care Needed Where to Go
Wait Time
from Phone
Call to Visit
Notes
Well Visits/
Annual Exams
Routine checkups
scheduled at
regular times, such
as once a year
PCP or your
doctor’s office
Within 30 days
Routine
Office Visits
Non-urgent office
visits with mild
symptoms, like a
sore throat
PCP or your
doctor’s office
Within 4 days
After-Hours
Care
Care needed
outside of your
PCP’s or doctor’s
office’s normal
business hours
Call your doctor’s
office to find out
where to seek
care or how to
get in touch with
a nurse or doctor.
You may also go
to an affiliated
urgent care center
Urgent Care
Serious but
non-emergency
injury or illness,
like sprained
ankles and minor
wounds
PCP or your
doctor’s office
or any affiliated
urgent care center
Same or next
day
Go to
hap.org
or call Client Services for a
list of affiliated urgent care centers. You can
use any affiliated urgent care center. Check
your ID card if you belong to an HMO plan
or Summary of Benefits and Coverage if you
belong to a PPO, an EPO, an EPA or a POS plan
for any cost-sharing amounts
Emergency
Care
An illness, injury,
symptom or
condition so
serious that
a reasonable
person would
seek care right
away to avoid
severe harm
Go to the nearest
emergency room
immediately or
call 911
You can get
emergency care
right away, 24
hours a day, 7
days a week, at
any emergency
room
worldwide
If you are admitted to a hospital not affiliated
with us after an emergency, be sure to call the
number on the back of your ID card within 48
hours to ensure payment for services. You may
be transferred to an affiliated hospital when you
are stable. If you decide to refuse the transfer,
then you will be responsible for payment for care
at the non-HAP or non-Alliance facility
Specialty Care
– HMO and
EPA Plans
Appointments
with specialists
for care not
provided by your
PCP
Call your PCP first
for a
recommendation
HMO and EPA plans: Talk to your PCP first
in order to schedule an appointment with
a specialist. Your PCP has good working
relationships with many highly qualified
specialists. If you choose a PCP in the Detroit
Medical Center (DMC), the Henry Ford Medical
Group (HFMG), ACCESS or Genesys network, you
will get specialty care from doctors within that
network. If you choose a PCP in any of our other
networks, you may be able to see specialists in
any HAP network
Specialty Care
– PPO, EPO
and POS Plans
Appointments
with specialists for
care not provided
by your doctor
The specialist
your doctor
recommends or
you choose
PPO, EPO and POS plans: We recommend that
you see a specialist after calling your PCP or
doctor first, but it’s not required. Remember,
EPO members don’t have out-of-plan coverage