What is defined as “urgently needed care”?

“Urgently needed care” refers to non-emergency medical services that are required promptly to prevent a problem from worsening, even though the situation is not life-threatening. It addresses immediate health needs that do not qualify as emergencies but still require timely attention to alleviate discomfort or prevent complications.

This type of care is particularly important in the context of Medicare Advantage plans, which must provide access to needed services outside of urgent and emergency situations. It distinguishes itself from emergency care, which involves life-threatening conditions, and routine check-ups, which are preventive and not time-sensitive. The focus is on ensuring individuals receive care for conditions that are significant enough to warrant immediate attention but do not pose an immediate risk to life.