After Hours, Urgent, and Emergency Care
Remember to always show your child’s Rady Children’s California Kids Care Member ID card when seeking medical care. Your child’s PCP phone number is listed on your child’s California Kids Care Member ID.
If your child has a medical emergency, call 911 or go to the nearest hospital emergency room for help. You do not have to go to the hospital where your child’s PCP works if your child has a medical emergency.
Non-Emergency Healthcare Services
Sometimes it’s difficult to know what kind of care your child needs. If you have any questions, please call California Kids Care Member Services at 1-844-225-5430 (TTY 711). Your healthcare team will be available to assist you by phone 24 hours a day, 7 days a week. This is known as “triage.” Here are some of the ways that triage can help you:
- Triage nurses can answer your questions about a health concern, and instruct you on self-care.
- They can advise you about whether you should get medical care, and how and where to get care (for example, if you are not sure whether your condition is an Emergency, they can help you consider whether you need Emergency or Urgent Care.)
- They can advise you on what to do if you need care and your Provider’s office is closed.
California Kids Care providers will make sure that you can speak with an authorized medical representative over the phone within a time period that is appropriate for your child’s medical condition. Please contact your Primary Practitioner at the number on your California Kids Care Member ID Card to use telephone triage services.
Urgent Care and Night and Weekend Care
There is a difference between urgent and emergency care. Urgent care is necessary when your child needs immediate attention, but the condition is not life threatening.
If your child feels sick or has a fever or an urgent medical problem, call your child’s Provider’s office. Your child’s Provider’s office is available for you at night and on weekends. Your child’s Provider or a doctor-on-call will always be available to tell you how to handle the problem at home or if you should go to an urgent care center or a hospital emergency room. Be sure to tell the Provider’s answering service that you have an urgent problem and need to speak to the doctor.
It’s always important to remember that even though urgent conditions are not emergencies they may nonetheless require prompt medical attention in order to address the situation. Please check the CKC Provider Directory for Urgent Care Centers.
If your child needs urgent care on a night or weekend and he/she is outside of the Service Area, contact your child’s Provider. If you cannot reach your child’s Provider, go to the nearest medical facility.
Your child is covered for emergency care, both within and outside California Kids Care’s service area. Emergency services are not subject to prior authorization by California Kids Care. Members can seek Emergency care at any available hospital.
If your child has a medical emergency, call 911 or go to the nearest hospital emergency room for help. You do not have to go to the hospital where your child’s PCP works if he/she has a medical emergency.
A medical emergency is a medical condition that causes severe pain or a serious illness or injury that a cautious, non-medical person reasonably believes, that without immediate medical care, could include:
- Put your child’s health in serious danger;
- If your child is pregnant, put your child’s health or the health of the unborn child in serious danger;
- Cause serious harm to the way your child’s body works;
- Cause serious damage to any body organ or part jeopardizing a person’s life or health;
- In the case of a behavioral condition, place the health of such person or others in serious jeopardy;
- Cause serious dysfunction of any bodily organ.
Services outside the United States
Your child will only be covered outside the U.S. if he/she needs emergency service and has to be admitted to a hospital. If you pay for emergency services for your child that required hospitalization, California Kids Care will only pay you the Medi-Cal allowable amount, which may be less than what you actually paid.
If your child is out of the country and gets sick but it is not a medical emergency, call your child’s PCP to find out what to do.