Get the care you need, when you need it
Know where to go
Your health care needs do not always follow a schedule. Learn where to go when you or your family needs care, no matter what time or day it is.
Your primary care provider (PCP)
Your primary care provider (PCP) is the doctor that you will see for most of your health care needs. When you are sick or hurt, always call your PCP first (unless it’s an emergency). Even if you call after hours, someone from the office should be on call and able to help.
Your PCP is listed on your member ID card and in your online profile. They will:
- Get to know you and your health history.
- Work with you to find specialists, treatment plans and medicines when needed.
If you have not seen your PCP before, call and make a new patient appointment as soon as you can. It is a good idea to see your PCP when you are well to help your doctor learn about your medical history before any health issues occur.
Need to change your PCP?
- To find a PCP in your plan, use our Find a Doctor search tool.
- To change your PCP, log in to your secure account and use our Change PCP tool. You can also call Member Services at 833-388-1405 (TTY 711).
24-Hour Nurse Help Line
833-388-1405 (TTY 711)
Health issues can come up when you least expect them. Our 24-Hour Nurse Help Line lets you talk with a registered nurse whenever you have health questions or need medical advice — day or night, holidays and weekends.
Our nurses can:
- Advise you on where to go when you need care.
- Help you with any health questions you have.
- Find a doctor after hours or on weekends.
An urgent medical condition is when care is needed for a sudden illness, injury or condition that is not an emergency but needs to be treated right away. There are no copays for urgent care visits covered by Medicaid.
You may need urgent care if you have:
- Minor burns.
- A very sore throat.
- An injury from a fall.
- Frequent vomiting.
- A cut that’s deep enough to need stitches.
- A fever over 101 degrees Fahrenheit.
- Muscle sprains or strains.
If you need urgent care
- During normal clinic hours, call your primary care provider (PCP). Their number is listed in your online profile.
- After hours and on weekends, visit an urgent care center.
Emergencies are times when there could be serious danger or damage to your health if you don’t get medical care right away. If you need emergency care, call 911 or go to the nearest hospital emergency room (ER). Preapprovals are not needed for emergency care. There are no copays for emergency services covered by Medicaid.
Go to the ER if you:
- Have chest pains.
- Have trouble breathing.
- Are bleeding badly.
- Are pregnant and have signs of harm to yourself or your baby like pain, bleeding, fever or vomiting.
- Feel like you might hurt yourself or someone else.
- Have a drug overdose.
After an ER or urgent care visit
Call your PCP as soon as you can after you visit the ER or urgent care center. Your PCP can help with your follow-up care. Their number is listed in your online account.
Not sure if it is an emergency?
Call our 24-Hour Nurse Help Line at 833-388-1405 (TTY 711). Our nurses can tell you whether you need emergency care or help you find an urgent care center.
Behavioral health care
You do not need to see your PCP before getting behavioral health services. If you need help finding mental health or substance use services, call Member Services at 833-388-1405 (TTY 711).
If you are having any of the following feelings or problems, you should contact a behavioral health doctor:
- Constantly feeling sad
- Feeling hopeless and/or helpless
- Feelings of guilt
- Feelings of worthlessness
- Difficulty sleeping
- Poor appetite
- Weight loss
- Loss of interest
- Difficulty concentrating
- Constant pain such as headaches, stomachaches and backaches
If you think you are in danger of harming yourself or others, call 911 or go the nearest emergency room.
24/7 Behavioral Health Crisis Line — 833-405-9087 (TTY 711)
If you are experiencing a mental health crisis, call our 24/7 Behavioral Health Crisis Line at 833-405-9087 (TTY 711) for help. If a situation is life-threatening, always call 911.