Preventive care 

Regular checkups are an important part of staying healthy. One Health Plan covers a full range of preventive care services: well-newborn care, routine physicals, immunizations, basic gynecological care, mammograms and more. 

Your PCP is also a great source of practical health care information. He or she can provide information on topics such as nutrition, exercise and stress management. 

Specialist care 

The One Health Plan HMO network includes doctors in almost every medical specialty. When you need specialist care, your PCP will refer you to a One Health Plan specialist who participates in his or her medical group. 

Hospital care 

If you need nonemergency hospital services, make sure treatment is approved by your PCP. Your One Health Plan provider will refer you to a network hospital affiliated with his or her medical group. Our providers also use Centers of Quality Care — institutions specializing in liver, kidney, heart and bone marrow transplants — so we can offer our members the medical care they need in these specific situations. 

Maternity care 

Healthy babies begin with healthy mothers. As soon as you suspect you're pregnant, you'll want to see your PCP or self-refer to a network OB/GYN. (Your PCP may be able to suggest some good OB/GYNs in your area.) It's important to establish a relationship with your provider right away, so you can get started with your prenatal visits and prepare for the delivery of your baby.

Within the first 12 weeks of your pregnancy, you should also call Great Beginnings, our maternity assessment program, at (800) ONE-8081. You’ll speak with a maternity nurse who will ask you a few basic questions about your medical history and follow the progress of your pregnancy. You’ll also receive educational information that will help you through those very important nine months. 

Emergency care 

One Health Plan provides worldwide coverage for true emergencies or urgent care. If you become sick or injured and believe waiting to see your provider could result in serious jeopardy to your health, go immediately to the nearest health care facility. You also have the option of calling 911 or the local equivalent. Then you, or someone on your behalf, must notify your PCP within 72 hours, or as soon as possible. 

Urgent Care 

If you're certain you need same-day or next-day care, you can go to a local urgent care facility without his or her approval. Just inform your PCP within 72 hours (or as soon as reasonably possible).

Mental health care 

With One Health Plan, getting the right kind of mental health care is easy. Just call One Health Plan’s managed mental health line at (800) ONE-8081. You’ll speak with a trained counselor who will refer you to a provider who’s right for you. One Health Plan’s managed mental health program is staffed with a network of mental health professionals. 

To receive approval for treatment, you must call the managed mental health number for referral to a One Health Plan provider. You may call the managed mental health line during normal business hours. We’ll approve necessary care. Do not call your PCP.* 

 
*Illinois members may get a referral from their PCP or the managed mental health line. Members of Texas' small employer plans must get a referral from their PCP. Small employer plans are companies with 50 employees or less. If you're unsure, contact your plan administrator.