Need Help Understanding Your Health Plan? Ask a Member Advocate.
Posted On: 11/30/2023
Health insurance is an important tool for staying healthy – but sometimes, it can be challenging to make sense of your coverage. You may need help understanding your benefits, but you’re not sure where to start.
If you’re a PCHP member, you can get help from one of our Member Advocates.
What does a Member Advocate do?
PCHP’s Member Advocates help members with:
- Writing and filing complaints and appeals.
- Understanding their rights and responsibilities.
- Locating community resources and specialists.
- Escalating problems such as billing issues.
What are some reasons you might talk to a Member Advocate?
Member Advocates can help address common member questions and concerns like:
- Whether you qualify for certain benefits coverage.
- Why you are receiving a bill from your doctor.
- If you need help finding specialists with appointment availability in your area.
- Why prior authorization for services was denied.
- How to renew your Medicaid benefits.
Healthcare can be complicated and full of confusing words and definitions. Member Advocates are here to help you understand your coverage and take a more active role in your own health. When you feel comfortable asking questions and sharing your concerns with your provider, it can lead to better care.
What is a PCHP resource that can help members improve their health literacy?
PCHP’s Member Portal is a great resource for members. You can use the portal to:
- View recent claims.
- Find a provider or facility.
- View your ID card.
- Find a vision provider.
- Access behavioral health resources.
- Find an in-network pharmacy.
- Access the Member Rewards site.
How can I contact a Member Advocate?
Call PCHP Member Services at 1-888-672-2277 (STAR) or 1-888-814-2352 (CHIP), 8 am – 5 pm Monday–Friday (except state holidays).
Interested in sharing your opinions about PCHP?
Join our Member Advisory Committee! You can be part of surveys and group discussions about different health topics. The panel meets once a quarter (virtual format). With your help, we can improve the services we offer. Contact us today to learn more!