Need Help Understanding Your Health Plan? Ask a Member Advocate.
November 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 (HEALTHfirst/STAR Medicaid) or 1-888-814-2352 (KIDSfirst/CHIP), 8 am – 5 pm Monday–Friday (except state holidays).
Sign up for the PCHP Member Portal and earn a reward!
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!
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