Primary Care

The types of services you get with routine care include:  

• Check-ups.
• Shots.
• Treatments.
• Prescriptions.
• Tests and screenings.
• Health education and counseling.

You will get all of your routine care from your primary care provider (PCP). Your PCP will:

• Get to know your health history and needs.
• Keep your health records.
• Give you the preventive and routine care you need.
• Refer (send) you to a specialist if you need one.
• Arrange for hospital care if you need it.

You can get primary care as soon as your coverage starts. As a new Alliance member, you should see your new PCP for an initial health assessment within 120 days of becoming an Alliance member so they can learn about you and your health.

Remember to do the following when you call to schedule your new patient exam:

• Tell the person who answers the phone that you are a member of the Alliance.
• Give your Alliance ID number.
• Take your Alliance ID card, BIC and any other health insurance cards to your appointment.

Be ready to talk with your PCP about your health care needs and concerns. It is a good idea to take a list of your medications and questions with you to your visit.

Practicing good communication with your doctor is important to ensuring that your health care needs are met. Clear and honest communication between you and your PCP can help you feel safe to voice your concerns and make informed choices.

We know that talking with your PCP is not always easy but open communication will lead to increased satisfaction with your doctor. Below are some examples of topics to discuss with your PCP if you have health concerns during your visit.

Other tips for your visit to the doctor:

• Bring a list of all the medications you are taking.
• If you have any medical needs, such as wheelchair access, or require language assistance or interpreting services, let the doctor’s office staff know so they can help you.
• Ask what the office policy is for missed appointments. The office can help to reschedule appointments or provide other options, such as phone appointments, if it is difficult to go to the doctor in person.
• If you do not have transportation to your appointment, the Alliance can help with transportation services. Contact Member Services at 800-700-3874 (TTY: Dial 800-735-2929 or 711) for more information.

After your new patient exam, you can continue to get routine care from your PCP. When you need routine care, call your PCP to schedule an appointment.

It is important to know that routine care is not urgent care or emergency care.

Urgent care is care you need to prevent serious damage to your health from a sudden illness, injury or complication of a condition you already have.

• For urgent care concerns, call your PCP.
• If you cannot reach your PCP, call Member Services at 800-700-3874 (TTY: Dial 800-735-2929 or 711).
• You can also call the 24/7 Nurse Advice Line at 844-971-8907 (TTY: Dial 711).

Emergency care is for life-threatening medical conditions.

• For an emergency, call 911 or go to the nearest emergency room.
• If you are not sure if your medical condition is an emergency, call your PCP.
• You may also call the 24/7 Nurse Advice Line at 844-971-8907 (TTY: Dial 711).

Examples of emergency care may include, but are not limited to:

• Active labor.
• Broken bone.
• Severe pain.
• Chest pain.
• Severe burn.
• Drug overdose.
• Fainting.
• Severe bleeding.
• Psychiatric emergency conditions, such as severe depression or suicidal thoughts.

Do not go to the ER for routine care. You should get routine care from your PCP, who knows you best.

As a new Alliance member, you can choose your PCP from a list of providers in the Alliance network. If you do not choose a PCP within 30 days, the Alliance will choose one for you.

• View detailed instructions on how to choose your PCP. You must confirm your choice with the Alliance.
• View the Provider Directory.

To change your PCP, use the online form or call Member Services at 800-700-3874 (TTY: Dial 711). They are open from 8 a.m. to 5:30 p.m., Monday through Friday. Changes will start the first day of the next month.