Access to Care
When you access physical, behavioral, and dental care at the right place and time, it helps you stay healthy. Your providers can find and treat issues earlier. This can lead to better outcomes.
Choose a provider who can be a good partner in your care. Trillium is here to help connect you to the right provider. We also want to make sure that you receive services and supports in a way that respects your culture. We want to make sure that all communications (verbally/written) are in a language that you understand.
Trillium provides timely access to care and covered services, 24 hours a day and 7 days a week, when you medically need it. You can call Trillium if you need help getting care.
There might be a time that you need specialty behavioral health services. These services offer more intensive care programs than you can get at an office, hospital or residential care setting. These services support you with challenges like quitting street drugs or dealing with traumatic events. Specialty behavioral health services are available to all members when they need them. Some members are eligible to access the services immediately based on need.
This chart shows the timeframes when you should expect to receive care:
|Type of care you need||How urgent you need it||When you should expect to be seen|
|Physical Health Care||Emergency||You should be seen right away at your provider’s office, or referred to an emergency department.|
|Physical Health Care||Urgent||You should be seen within 72 hours or as needed, based on initial screening at your providers office.|
|Physical Health Care||Well Care and Routine||You should have an appointment to be seen within four weeks.|
|Dental Health Care||Emergency||You should be seen or treated within 24 hours when you go to the Emergency Department.|
|Dental Health Care||Urgent||You should have an appointment within one week or as needed based on initial screening by the dental office.|
|Dental Health Care||Routine||You should have an appointment within eight weeks, unless there is a special health reason that makes a wait of longer than eight weeks okay.|
|Dental Health Care||Routine – Pregnant||You should have an appointment within four weeks for initial dental screening or exam, or routine dental care.|
|Behavioral Health Care||Emergency||Go to a crisis center or emergency department right away.|
|Behavioral Health Care||Urgent||Call your behavioral health provider to be seen within 24 hours. If they cannot get you in, go to a crisis center or emergency department.|
|Behavioral Health Care||Routine||Call your behavioral health provider to set up an appointment. You should receive an assessment within seven days of asking for an appointment.|
Specialty Behavioral Health Services for Prioritized Population:
|Specialty Behavioral Health Services for:Intravenous (IV) Drug use, including heroin||Immediately||
|Specialty Behavioral Health Services for: Opioid use disorder||Urgent||
|Specialty Behavioral Health Services for: Medication Assisted Treatment (MAT)||Urgent||
|Specialty Behavioral Health Services for: Children ages birth to 21 years of age with serious emotional disturbances||Immediately||