Emergency Care
Benefits
When every second counts, your coverage is already there.
In an emergency, your only job is to get care — fast. Solo treats emergency services as in-network no matter where you are or which hospital you reach, so there's never a reason to hesitate, check a directory, or worry about the network first. Here's what qualifies, how coverage works, and what to do after the crisis passes.
An emergency is any medical condition with acute symptoms — including severe pain — serious enough that a reasonable person would believe that not getting immediate medical attention could seriously jeopardize their health, bodily functions, or organs. Emergency services include the initial evaluation, treatment, and stabilization of that condition.
Examples include:
- Chest pain or heart attack symptoms
- Severe difficulty breathing
- Major injuries or broken bones
- Uncontrolled bleeding
- Sudden loss of consciousness
- Suspected stroke
When it's truly an emergency, go to the ER — no hesitation. But for everything below that line, you have faster and less expensive options:
- Virtual urgent care — $0, 24/7. For flu, respiratory symptoms, UTIs, allergies, pink eye, and similar needs, your membership includes on-demand virtual urgent care through Clever Health at no cost per visit, day or night.
- Urgent care clinics. For minor injuries and illnesses that need hands-on attention but aren't life-threatening — covered at 100% after your deductible, typically with far shorter waits than an ER.
- The ER. For true emergencies — always treated as in-network, at any hospital.
Rule of thumb: if there's any real doubt about whether it's life-threatening, treat it as an emergency and go. Cost should never be the reason you hesitate.
- Every emergency is treated as in-network. Whether the nearest hospital participates in the Multiplan PHCS (now Claritev) network or not, your emergency care is processed as in-network. Go to the closest ER — the network question simply doesn't apply in an emergency.
- Covered at 100% after your deductible. Eligible emergency care applies toward your deductible; once you've met it, covered care is paid at 100% for the rest of the plan year. Your deductible is also your out-of-pocket maximum, so there's no added percentage on top.
- Covered while traveling. Emergencies are covered at any hospital nationwide — and emergency care while traveling abroad is covered too.
- Protected from surprise bills. Federal protections also limit surprise billing for emergency care. If a balance bill ever shows up after an emergency, don't just pay it — our OccuNet team reviews and helps resolve it on your behalf.
The Key Point: In a medical emergency, you are only responsible for meeting your deductible.
- In an emergency, just go. Head to the nearest hospital — or call 911. Don't stop to check the network, and don't let cost enter the decision.
- Share your ID card when you can. Once you're stable, give the hospital your ID card (digital or physical) so they can bill Vault Admin Services directly.
- If you're admitted, the hospital should coordinate authorization for the ongoing stay with Vault Admin Services — emergency treatment itself never needs advance approval, but extended stays generally do.
- Move follow-up care in-network. Once the crisis is over, scheduling follow-up and ongoing treatment with in-network providers keeps your costs predictable — our network page makes it easy to find them.
- Confirm the hospital billed Vault Admin Services. Most will, using the information on your ID card. If the facility won't bill directly, you can submit the claim yourself through your Member Portal — the claims submission guidance walks you through it.
- Keep every bill and document. Itemized bills, discharge papers, receipts — hold onto everything until the claim is fully processed.
- Compare your EOB to any bill before paying. When your Explanation of Benefits arrives, check it against what the hospital sent you. If the numbers don't match — or a surprise balance bill appears — contact Vault Admin Services at 888-211-5706 before paying anything.
Remember:
In a life-threatening situation, get care immediately — whether in-network or not. Your safety always comes first. When the crisis is over, moving follow-up care in-network keeps your costs predictable.
Questions about emergency coverage or a recent visit?
Remember:
In a life-threatening situation, get care immediately—whether in-network or not. Your safety always comes first. But when the crisis is over, choosing in-network can make a big difference to your out-of-pocket costs.