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Frequently Asked Questions


 

Accessing Care

How do I obtain emergency care? When should I call 911 instead?

 How do I obtain primary care services?

How do I obtain specialty care, behavioral healthcare services and hospital services?
 
How do I get care after normal office hours?

What does "Open Access HMO" mean?

Benefits

What benefits and services are included and excluded from my coverage?

How can I find my copays and other charges for which I am responsible?

What benefit restrictions apply to services obtained outside FirstCare's system or service area?

What does "not mutually exclusive" mean?

Claims

How do I submit a claim for covered services?

What should I do if I get a bill that should have been paid by FirstCare?
Call Customer Service at 1-855-572-7238.
 
How do I get a copy of my Explanation of Benefits (EOB)

Customer Service

What is the Customer Service phone number?

How can I obtain language assistance?
 
How do I voice a complaint?

How do I appeal a decision that adversely affects coverage, benefits or my relationship with the organization?

Miscellaneous

How can I add or delete someone from coverage under my plan?
If you are an active employee, contact your Benefits Coordinator.
 
How does FirstCare evaluate new technology for inclusion as a covered benefit?

Out-of-Network

How do I obtain care and coverage when I am out of FirstCare's service area?

What kind of coverage will my college-age child have while he or she is away at school?

I am currently seeing a doctor outside of FirstCare; can I continue to see that doctor?

How do I get a referral outside the FirstCare network when you cannot provide the services that I need?

What happens if I am hospitalized outside the service area?

Pharmacy

What are your pharmaceutical management procedures?

Providers

How do I obtain care and coverage when I am out of FirstCare's service area?

If I want to designate a primary care physician (PCP), how do I select a primary care physician?

What if I do not like my PCP after I have designated him or her?
You can change your PCP anytime.
 
Do all family members need to use a PCP/or the same PCP?

Benefits

What is the Member Portal address?

What are the benefits of registering online and using the Member Portal?

My Member Portal account is locked. What do I do now?

Why did my account become locked in the first place?

I just reset my password and still can't log in. What can I do?

I reset my password and tried all my email addresses, but I still can't get in. What do I do now?

I tried the reset password feature, but I never got an email or I got an error when trying to reset my password. What is wrong?

I tried resetting my password several times and nothing is working.

I am brand new to the Member Portal and want to set up an account. I went through the registration process and used my Social Security Number, but it says “no member found.” I know my SSN and Date of Birth are correct. What is wrong?

I put in my member ID number and date of birth but still cannot register for the Member Portal. How can this be?

What browsers does the FirstCare Member Portal support?

Recursos

We put you first

Contact our Customer Service team for assistance.

Get Case Management assistance

If you need assistance with an urgent medical issue, click here to reach out to our Case Management Team.

Talk to a Nurse
24-Hour Nurseline

Need care advice? Should you see a doctor? Get the info you need today! FirstCare members can talk to a nurse 24/7 by calling 1-877-505-7947 to get answers 24 hours a day, 7 days a week! TTY users can call 711.

Behavioral Health Services

Having a tough time? Need to talk to someone? Make the most of your FirstCare benefits & call us at 1-800-327-6943 for 24/7 assistance with what's troubling you.

Community Resources

Click here for valuable resource information—programs, events, support groups, educational sessions, volunteer opportunities, and more—available throughout the communities we serve.

Our Service Area Maps

Commercial HMO and PPO
Marketplace Individual/Family Medicaid STAR/MRSA CHIP

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