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HHRC-EOC 02.10.2017 4 Evidence of Coverage <br />What To Do When You Require Emergency Services <br />If you believe that you need Emergency Services, you should call 911 or go to the nearest <br />emergency medical facility for treatment. Plan does not cover emergency medical services. <br />It is appropriate for you to use the 911 emergency response system, or alternative emergency <br />system in your area, for assistance in an emergency situation described above when ambulance <br />transport services are required and you reasonably believe that your condition is immediate <br />and serious and requires emergency ambulance transport services to transport you to an <br />appropriate facility. <br /> <br />IV. CRISIS INTERVENTION <br />If you need crisis intervention or problem solving, call Plan at 1-800-342-8111. Plan provides <br />crisis intervention both during and after business hours at this number. A member who is <br />currently outside Plan’s service area and requires this service can call 1-800-342-8111. <br />Members can obtain care if they are temporarily outside of Plan’s service area. Members can <br />also be scheduled for an appointment on an urgent basis following assessment by a licensed <br />clinician over the telephone. <br /> <br />V. PREPAYMENT OF FEES <br />The Member does not pay co-payments, deductibles, or fees for Plan. All fees are paid by <br />Group. <br /> <br />VI. CHOICE OF EAP PROVIDERS <br />PLEASE READ THE FOLLOWING INFORMATION SO YOU WILL KNOW FROM <br />WHOM OR WHAT GROUP OF PROVIDERS BENEFITS MAY BE OBTAINED: You <br />will be referred to an EAP Provider in accordance with your clinical, appointment time, and <br />location needs. You should call Plan at 1-800-342-8111 to determine the names and locations <br />of EAP Providers. <br />EAP contracted providers include licensed psychologists, licensed clinical social workers, and <br />licensed marriage and family therapists. Psychiatrists are not provided through the EAP. <br />Members are given names of contracted providers in their area with knowledge in the problem <br />area that is indicated. You may also request a list of providers, and this will be provided for <br />the geographic area, customized by specialty, if you prefer. <br />REV: 03-10-23 MI <br />ATTY/AGR.2023.039/Aetna (EAP Services Agreement) (Page 28 of 42)