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As a Passport Health Plan member, you can choose
your primary care provider (PCP). You may choose one of the following
to be your PCP:
- General Practitioner
- Family Practitioner
- Nurse Practitioner
- Physician Assistant
- Internist
- Pediatrician (usually sees only children and adolescents)
- OB/GYN Provider
If you do not choose a PCP, Passport Health Plan will assign one
to you.
Your PCP works with you to get to know your health history and
help take care of your health. You can choose the same primary care
provider (PCP) for the entire family. Or you can have a different
PCP for each family member. Members with Medicare and Passport Health
Plan, or children living in out-of-home placement (foster care,
etc) do not have to choose a PCP and will not be assigned to one.
However, we encourage all members to choose a PCP.
You should always call your PCP’s office when you have a
question about your health or medical care. He or she can help you
get other services you may need.
*A list of PCP’s can be found in the Primary Care
Provider & Direct Access Services Directory that comes with
this Handbook.
What to Expect From Your Primary Care
Provider (PCP)
 Below
are some things your PCP will do for you:
- Give you the medical services you need or set them up for you.
- Keep your medical records up-to-date. This includes records
from any other providers you may see.
- Give you regular physical exams, as needed. This includes EPSDT
services for members under 21. See the Preventive Health Guidelines
in the back pocket of this Handbook.
- Give you regular immunizations (shots), as needed.
- Keep track of your preventive health needs – such as screenings
and immunizations (shots).
- Make sure you can contact him or her or another provider at
all times.
- Refer you to a specialist, if needed.
- Set up other medical services you need.
- Set up medical care at hospitals, if needed. The hospitals must
be signed up with Passport Health Plan.
- Give you information about your health.
- Talk with you about advance medical directives. See the “Advance
Health Directive” section on page 30.
- Prescribe medicines when you need them.
Getting Care From Your PCP
You should usually call for an appointment to see your primary
care provider (PCP) or other provider. If you cannot keep an appointment,
call right away to let the office know. You can make another appointment
at that time. Please be sure to arrive on time for your appointment.
Be sure to take your Passport Health Plan ID card and your Medicaid
ID card.
The following tells how soon you can expect to receive certain
types of care:
Office waiting times
- You may wait about 15 - 45 minutes for your appointment. However,
if the PCP or other provider has an emergency, you could wait
- You may have longer wait times if your PCP’s office is
a walk-in clinic.
If you feel that your provider is not seeing you as stated
above, please call Member Services.
Routine appointments and preventive care
- You should be given an appointment within 30 days for:
- New patient visits
- School exams
- Routine physical exams
- Health screenings
- Vision exams
- Lab test and x-ray
Changing Your Primary Care Provider
You can change your PCP yearly or more often based on certain situations.
If you decide to change your PCP, call Member Services and tell
them the name of the new PCP you would like to select. If the PCP
is approved, Passport Health Plan will send you a new ID card that
lists your new PCP. Your PCP change will be effective the first
day of the next month. You will receive a new card about two weeks
after you call us with your new choice.
If you need medical care before you get your new ID card, call
Member Services.
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