Your insurance plan may need to know your PCP

Your insurance plan may need to know your PCP

A primary care provider (PCP) is your main medical provider, working with you on managing many of your preventative and chronic healthcare needs, including coordinating care with specialists.

Many health plans require or recommend that you notify them of your chosen PCP. It's an important detail that may impact your access to specialists, prior authorization on certain procedures and out-of-pocket expenses. And you can change it at any time.

In addition, any insurance plan that is an HMO, EPO, or POS network may automatically assign you a PCP if you do not notify them of your selection. Please reach out to your health plan to check their specific requirements.

These HMO plans REQUIRE you to notify them who your PCP is:

Exchange HMO Plans

  • Ambetter Value Network (look for Value Network on the card)
  • Ambetter Virtual Care
  • Aetna CVS Exchange (look for the Aetna CVS logo)
  • MyBlue
  • Blue Advantage
  • Moda Health
  • UnitedHealthcare Exchange/Virtual First (look for Exchange on the card)

Commercial/Employer HMO Plans

  • Aetna
  • Blue Cross
  • Cigna
  • Humana
  • UnitedHealthcare
  • and more, check with your plan

These Medicare Advantage plans do not require it, but we strongly encourage you to notify them of your ARC PCP to ensure your provider can better coordinate your healthcare:

  • Aetna Medicare Advantage Plans
  • Blue Cross Medicare Advantage Plans
  • Humana Medicare Advantage Plans
  • UnitedHealthcare Medicare Advantage Plans
  • Wellmed/AARP Medicare Advantage Plans

Your ARC care team wants to provide the most coordinated care to benefit you and your family's health. Thank you for being part of the team effort.

Tags: Insurance