Using Your Primary Care Provider

What is a PCP and what do they do?

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.

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 check-ups, follow-up care if needed and regular care during pregnancy.

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 Member Services at 1-833-704-1177 (TTY 1-855-534-6730). We will work with you to help coordinate the care that you need.

How do you choose your PCP?

When you enroll in AmeriHealth Caritas New Hampshire, you will have an opportunity to choose your own PCP. To choose your PCP, call Member Services at 1-833-704-1177 (TTY 1-855-534-6730) or log in to our member portal.

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

Changing 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 New Hampshire ID card. Just call Member Services at 1-833-704-1177 (TTY 1-855-534-6730). 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 once 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 1-833-704-1177 (TTY 1-855-534-6730) to learn more about how you can change your PCP.

At your appointment

Before each visit with your PCP, review this helpful checklist (PDF) to determine how you're feeling. This checklist can act as a conversation starter between you and your provider and can also help make sure you're staying on top of your health.

It is important to be on time for your appointment. If you are going to be late or need to cancel your appointment, call the PCP's office and let the office know. If you need to reschedule, try to let the PCP's office know at least 24 hours before the appointment.

At your visit your PCP may:

  • Learn your health history and keep your records up to date.
  • Answer questions about your health.
  • Give you information about healthy eating and diet.
  • Give you the shots and screenings you need.
  • Help you get care from other providers, if you need it.
  • Find problems before they become serious.
  • Give Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for members younger than 21 years old.
  • Give preventive treatment for conditions like diabetes, high blood pressure, asthma and heart disease.

Listen carefully to any directions the PCP gives you. If there is something you do not understand, ask for help.

We can help you pick a PCP or set up an appointment. Call AmeriHealth Caritas New Hampshire Member Services, 24 hours a day, seven days a week, at 1-833-704-1177 (TTY 1-855-534-6730).

Choose your pcp in the member portal.

What happens when a provider leaves our plan

We may make changes to the hospitals, doctors, and specialists (providers) that are part of our plan during the year. Also, sometimes your provider might leave the network. If your doctor or specialist leaves our plan, learn more about your rights and protections.