FAQs

A health plan is a group of doctors, hospitals, clinics and other health care providers. They work together to meet your health care needs. Health plans also keep track of your medical records.

When you get an enrollment packet in the mail, it will ask you to choose. You will choose a health plan and a primary care provider (PCP) who works with your health plan.

You will choose a plan in your county that works with Medical Assistance (Medicaid). Counties have three to five plans to choose from. To see the health plans in your county, go to Compare plans.

No. Each person can choose a different plan. Or you can all choose the same plan.

Yes. You can use the app to:

• Find primary care providers (PCPs) and hospitals
• Compare health plans
• Enroll in or change a health plan and PCP
• Find driving directions to nearby providers
• Get information in Spanish

To get the app, search for PA Enrollment Services on Google Play or the App Store. Download the free app today.

You must sign in with your Access Card ID or the last four digits of your Social Security number to use the app to enroll.

Once you choose a plan, there are three ways to enroll: online, by phone or by mail. To learn more, go to Enroll.

Yes, you can change your health plan at any time. If you choose a new health plan, make sure the PCP you want is in your plan’s network (group of providers). You can check your provider’s network at Find a provider.

If you don't get a health plan ID card from the health plan you chose, call your plan’s toll-free number. To see health plan phone numbers, go to Contacting Your Plan.

After you enroll, your health plan will send you a health plan ID card and a member handbook. Your handbook tells you how to get health care services.

If you got an ID card from a health plan you did not choose, call our PA Enrollment Services at 1-800-440-3989 (TTY 1-800-618-4225). Choose Option 2 (“confirm your health plan start date”). Once you confirm that you are in the plan you chose, you can throw away the information and ID card from the plan you did not choose.

If you are enrolled in a plan, call your plan's member services department at the phone number on Contacting Your Plan page. If you are not enrolled, please contact Customer Service Center at 1-877-395-8930 or in Philadelphia (215) 560-7226.

Yes. Use your ACCESS or EBT card to get health care services before your health plan start date. If you have questions, please contact Customer Service Center at 1-877-395-8930 or in Philadelphia (215) 560-7226.
 

Yes. Keep your ACCESS or EBT card even if your health plan sends you a new card.

You need to show your ACCESS card and your new health plan card every time you visit the doctor or get other health care services.

Your PCP is your doctor or other provider who gives you most of your regular health care. This includes checkups and other basic services. Your PCP works closely with you. Your PCP can send you to a specialist or hospital if you need those services.

Choose a PCP when you get your enrollment packet in the mail. You will choose a PCP who works with your health plan. Get tips to Choose a PCP.

No. Each person can choose a different PCP. Or you can all choose the same PCP.

Yes. You can change your PCP at any time by calling your health plan. It may take a few days for the change to happen. To see health plan phone numbers, go to Contacting Your Plan.

Yes, if your doctor works with one of the Medical Assistance (Medicaid) health plans in your county. To find out which health plans your doctor works with, go to Find a Provider.

If you don't have a doctor and want help choosing one, we can help. To search from doctors near you, go to Find a provider.

Or call our PA Enrollment Services at 1-800-440-3989 (TTY 1-800-618-4225). We can talk with you about the kind of doctor you are looking for. We can help you find a PCP close to where you live.

A specialist is a doctor who only takes care of one kind of health care need. Specialists include doctors who treat things such as heart problems, broken bones or certain cancers. Your PCP will send you to a specialist for care when you need to see one. This is called a “referral.” If you already have a specialist that you see, ask your PCP for a referral for future visits.

In some cases you can choose a specialist, such as an Ob/Gyn, to be your PCP. Call your health plan to learn more. To see health plan phone numbers, go to Contacting Your Plan.

Please contact your health plan to update your ID card with your PCP. You can find the phone number at Contacting Your Plan.

Please call your local county assistance office at the phone number on the Program resources page. Or call the Statewide Customer Service Center (CSC) toll-free number at 1-877-395-8930. In Philadelphia, call 1-215-560-7226.

Please call your local county assistance office at the phone number on the Program resources page. Or call the Statewide Customer Service Center (CSC) toll-free number at 1-877-395-8930. In Philadelphia, call 1-215-560-7226.

You will get behavioral health (mental health and required substance use treatment) services through a behavioral health (BH) plan. The BH plan you will have is based on the county where you live. To see the behavioral health plans and phone numbers, go to Program Resources.

Please call the Statewide Customer Service Center (CSC) toll free number at 1-877-395-8930 or in Philadelphia call 215-560-7226.

Read your health plan handbook to learn how to make a complaint. Then call your health plan about your complaint. For health plan phone numbers, go to Contacting Your Plan.

If you still want help, you can call our PA Enrollment Services at 1-800-440-3989 (TTY 1-800-618-4225).