Frequently asked questions
What if I lose my member ID card or didn’t get one?
You can order a new member ID card at no cost on our secure Member Portal. Or you can ask for a new one. Just call 1-855-463-0933 (TTY: 711). We’re here 8 AM to 8 PM, seven days a week.
How do I choose or change my primary care provider (PCP)?
If you want to choose or change your PCP, just call 1-855-463-0933 (TTY: 711). We’re here 8 AM to 8 PM, seven days a week.
You’ll get a new member ID card with the name of your new PCP on it.
What should I do if I get a bill?
Providers in our network should always bill us directly. But sometimes they make mistakes and ask you to pay for your services.
Did you get a bill for medical care or medications? Don’t pay the bill. Just contact us. We’ll contact the provider and take care of it for you.
Already paid a bill from a provider in our network? Just send us the bill with documentation of your payment. We’ll review the bill and let you know if we cover the services or medications.
Questions? Call us at 1-855-463-0933 (TTY: 711). We’re here for you from 8 AM to 8 PM, seven days a week.
How do I appoint a representative?
You can ask someone to act on your behalf by naming them as your “representative” for a:
- Coverage decision
Your representative can be:
- A friend
- A relative
- A doctor or another provider
- Another person
Contact us to give another person the right to represent you. Call 1-855-463-0933 (TTY: 711). We’re here for you from 8 AM to 8 PM, seven days a week. Ask for the appointment of representative form. You also can download and print a copy of the form.
You and your representative must both sign the form. A completed and signed form is valid for one year.
Does your representative hold durable power of attorney or guardianship papers? If yes, you don’t need the appointment of representative form.
How do I get care from providers outside our network?
You can get care from providers outside our network. But most often, you’ll have to pay for these services yourself if you don’t have:
- A referral from your PCP
- Prior authorization (permission beforehand, or PA)
We don’t cover these services from providers outside our network. Neither does traditional Medicare. Some exceptions include:
- Emergency care for services you urgently need
- Dialysis services when you travel outside your service area
- Other medical care that Medicare or Medicaid requires our plan to cover when the providers in our network can’t provide this care
You must get prior authorization before seeing a provider outside our network. If we approve, we cover these services as if you got the care from a provider in our network.
Need approval to see a provider outside our network? Call us at 1-855-463-0933 (TTY: 711). We’re here for you 8 AM to 8 PM, seven days a week. You can also check your Evidence of Coverage.
How do I get care during a disaster?
You still have the right to your health benefits if a state of disaster or emergency is declared in your geographic area by an authority like:
- State’s governor
- U.S. Secretary of Health and Human Services
- President of the United States
Can’t use a provider in our network during a disaster? Your plan generally allows you to get care from providers outside our network
Can’t use a pharmacy in our network during a disaster? You may be able to fill your prescriptions at a pharmacy outside our network.
Learn more about getting care in a disaster. Just check your Evidence of Coverage