Urgent care is not for an emergency or life-threatening condition. It is for services you need to prevent serious damage to your health from a sudden illness, injury or complication of a condition you already have.
Most urgent care appointments do not need pre-approval (prior authorization). If you ask for an urgent care appointment, you will get an appointment within 48 hours. If the urgent care services you need require a pre-approval (prior authorization), you will get an appointment within 96 hours of your request.
For urgent care, call your PCP. If you cannot reach your PCP, call Member Services at 1-888-839-9909 (TTY: 711). Or you can call the Nurse Advice Line 24 hours a day, 7 days a week, including holidays at 1-800-249-3619 (TTY 711), to learn the level of care that is best for you.
If you need urgent care out of the area, go to the nearest urgent care facility.
Urgent care needs could be:
- a Cold
- Sore throat
- Fever
- Ear pain
- Sprained muscle
- Maternity services
You must get urgent care services from an in-network provider when you are inside L.A. Care’s service area. You do not need pre-approval (prior authorization) for urgent care from in-network providers inside L.A. Care’s service area.
If you are outside the L.A. Care service area, but inside the United States, you do not need pre-approval to get urgent care. Go to the nearest urgent care facility.
Medi-Cal does not cover urgent care services outside the United States.
If you are traveling outside the United States and need urgent care, we will not cover your care.
Mental Health Urgent Care
If you need mental health urgent care, visit the Los Angeles County Department of Mental Health website or call their toll-free telephone number at 1-800-854-7771 or call L.A. Care Member Services at 1-888-839-9909 (TTY: 711).
You may call your county Mental Health Plan or your L.A. Care Behavioral Health Organization any time, 24 hours a day, 7 days a week.
If you are outside of Los Angles County, you can find the toll-free telephone numbers for all counties in California at the California Department of Health Care Services.
Prescription Drugs Related to Urgent Care
If you get medicines as part of your covered urgent care visit, L.A. Care will cover them as part of your covered visit. If your urgent care provider gives you a prescription to take to a pharmacy, Medi-Cal Rx will decide if it is covered.
To learn more about Medi-Cal Rx, go to the “Prescription drugs covered by Medi-Cal Rx” section of this handbook.