What is a Primary Care Physician (PCP)?
A Primary Care Physician (PCP) is a doctor you select under your health insurance plan to be your personal physician. A PCP can be specialized in Family Practice, General Practice, Family Practice or Pediatrics. The relationship you have with your PCP is very important because he/she is responsible for managing all aspects of your care. Your PCP is responsible for referring you to specialty physicians.
What is a medical group?
When you choose a Primary Care Physician (PCP) you also choose his/her medical group. A medical group is formed when primary care physicians come together to contract with health plans and serve the community. These physicians have contracted with specialist physicians, hospitals and other health care providers to form a network.
What if I need care after hours?
In case of an emergency situation call 911 or go to the nearest emergency room. If your situation is not emergent and your primary care physician’s office is open, call the physician’s office directly for advice. Otherwise, visit one of our contracted urgent care centers.
How do I change my Primary Care Physician (PCP)?
You may change your PCP by calling DHMN Customer Service at 716-7100 and/or calling the toll free number listed on your health plan ID card.
How do I know if my plan provides coverage for the care my physician wants to prescribe?
You may contact DHMN Customer Service at 716-7100 or contact your health plan. It is your responsibility to know your benefits.
What if the information on my ID card is incorrect?
It is extremely important that the information on your card be correct. If you note any errors, contact your health plan immediately to correct the information. Remember to make sure your physician has a copy of your ID card.