Choosing Your Primary Care Provider
Your primary care provider (PCP) is a doctor, nurse practitioner, physician assistant, or another type of provider who will care for your health, coordinate your needs, and help you get referrals for specialized services if you need them.
When you enroll in AmeriHealth Caritas Ohio, you will have an opportunity to choose your own PCP. To choose your PCP, call Member Services at 1-833-764-7700 (TTY 1-833-889-6446). If you do not select a PCP, we will choose one for you. You can find your PCP’s name and contact information on your ID card.
When deciding on a PCP, you may want to find a PCP who:
- You have seen before
- Understands your health problems
- Is taking new patients
- Can serve you in your language
- Is easy to get to
Each family member enrolled in AmeriHealth Caritas Ohio can have a different PCP, or you can choose one PCP to take care of the whole family. A pediatrician treats children. Family practice doctors treat the whole family. Internal medicine doctors treat adults. Call Member Services at 1-833-764-7700 (TTY 1-833-889-6446), to get help with choosing a PCP who is right for you and your family.
You can find the list of all the doctors, clinics, hospitals, labs, and others who contract with AmeriHealth Caritas Ohio in our online provider directory. You can also call Member Services at 1-833-764-7700 (TTY 1-833-889-6446), to get a copy of the provider directory.
Choosing an OB/GYN
Women can choose an OB/GYN to serve as their PCP. Women do not need a PCP referral to see a plan OB/GYN doctor or another provider who offers women’s health care services. Women can get routine checkups, follow-up care if needed, and regular care during pregnancy.
Choosing a specialist
If you have a complex health condition or a special health care need, you may be able to choose a specialist to act as your PCP. For more information or to request to choose a specialist as your PCP, call AmeriHealth Caritas Ohio Member Services at 1-833-764-7700 (TTY 1-833-889-6446). We will work with you to help coordinate the care that you need.
If your provider leaves our network
If your provider leaves AmeriHealth Caritas Ohio, we will tell you within 15 days from when we know about it. If the provider who leaves AmeriHealth Caritas Ohio is your PCP, we will contact you to help you choose another PCP within seven days from when we know about this. See Transition (continuity) of care for more information.
How to change your PCP
You can find your primary care provider’s (PCP’s) name and contact information on your ID card. You can change your assigned PCP within 30 days from the date you receive your AmeriHealth Caritas Ohio ID card, or within 30 days from the date you receive notification of your PCP assignment. Just call Member Services at 1-833-764-7700 (TTY 1-833-889-6446). After that, you can change your PCP up to one time each year. You do not have to give us a reason for the change.
If you want to change your PCP more than one time a year, you can change at any time if you have a good reason (good cause). For example, you may have good cause if you:
- Disagree with your treatment plan.
- Your PCP moves to a different location that is not convenient for you.
- You have trouble communicating with your PCP because of a language barrier or another communication issue.
- Your PCP is not able to accommodate your special needs.
Call Member Services at 1-833-764-7700 (TTY 1-833-889-6446), to learn more about how you can change your PCP, or log in to our member portal.
If you have any questions, call Member Services at 1-833-764-7700 (TTY 1-833-889-6446).