Choosing Your Primary Care Provider
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.
Your care when you change health plans or health care providers
If you join AmeriHealth Caritas New Hampshire from another health plan, please read our section on continuity of care for more information.
What happens when a PCP, specialist, or another network 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, you have certain rights and protections described below:
- When possible we will notify you when your PCP or other provider who you receive routine treatment from leaves the plan's network. We will notify you the earlier of 15 calendar days after the plan receives notice of your provider leaving the network or 15 calendar days prior to the effective date of the provider termination so that you have time to select a new provider.
- We will assist you in selecting a new qualified provider to continue managing your health care needs.
- If you are undergoing medical treatment you have the right to request, and we will work with you to ensure, that the medically necessary treatment you are receiving is not interrupted.
- If you believe we have not furnished you with a qualified provider to replace your previous provider or that your care is not being appropriately managed, you have the right to file a grievance or an appeal of our decision.
- If you find out your doctor or specialist is leaving our plan, please contact us so we can assist you in finding a new provider to manage your care.
- You may choose your preferred network health providers to the extent possible and appropriate.
- If you are receiving a prior authorized ongoing course of treatment with a participating provider who becomes unavailable to continue to provide services, the plan will notify you in writing within seven calendar days from the date the plan becomes aware of such unavailability and will develop a transition plan to help you with your continued ongoing care.
Before each visit with your PCP, review this helpful checklist to determine how you're feeling (PDF). 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.
If you have any questions, call Member Services at 1-833-704-1177 (TTY 1-855-534-6730).