FAQ
AmeriHealth® HMO
What is an HMO (Health Maintenance Organization)?
I’m a new member of AmeriHealth HMO, and I have some questions about my coverage. Who should I call?
I have just moved and now need a new primary care physician (PCP). What should I do?
What should I do if I need a doctor and my PCP is unavailable?
My ID card lists my doctor’s office name, not his/her individual name. Do I still see the same doctor?
We are expecting our first child. How do we enroll our baby in AmeriHealth HMO?
How do I get a prescription filled for my newborn baby before I get his/her ID card?
What is an HMO (Health Maintenance Organization)?
A Health Maintenance Organization is an organized system of health care using a designated panel of physicians and other health care personnel that provides comprehensive medical services for a fixed dollar amount per enrolled person. An HMO provides a complete range of medical benefits through a network of doctors and hospitals. One doctor, the primary care physician (PCP) — family doctor or pediatrician — coordinates overall medical needs. The PCP refers most specialty care needs.
I’m a new member of AmeriHealth HMO, and I have some questions about my coverage. Who should I call?
Call the number on the back of your ID card. If this number is not available, call the AmeriHealth Member Services Department at 1-800-877-9829, Monday through Friday, 8 a.m. to 6 p.m.
I have just moved and now need a new primary care physician (PCP). What should I do?
There are two ways to change your PCP:
- Online: To change your doctor, visit amerihealthexpress.com, our simple, convenient, and secure member portal. To find a new doctor, use the online provider search.
- Phone: Call the number on the back of your ID card. If this number is not available, call the AmeriHealth Member Services Department at 1-800-877-9829.
Primary care physician changes become effective on the first of the following month.
What should I do if I need a doctor and my PCP is unavailable?
As a member of AmeriHealth HMO, you have medical care available to you 24 hours a day, seven days a week, through your PCP’s office. If your PCP is unavailable, there will be a physician on call in the event of an emergency. When you call your PCP and get an answering service, be sure to tell the operator what your problem is and if it is an emergency. The service will have the covering physician call you promptly.
My ID card lists my doctor’s office name, not his/her individual name. Do I still see the same doctor?
Yes, you still see the same doctor. If you receive a new ID card and your doctor practices with a group of doctors in an office, the group name will be on your card instead of the individual doctor’s name. You may, however, still see the same doctor as before.
We are expecting our first child. How do we enroll our baby in AmeriHealth HMO?
For the first 31 days after the birth of your baby, your new baby is covered under your AmeriHealth HMO plan. You must complete an application to enroll your child with AmeriHealth within those 31 days.
How do I get a prescription filled for my newborn baby before I get his/her ID card?
If you have a prescription drug plan, you can get your baby’s prescription filled by paying for it at the pharmacy and calling Member Services for a reimbursement form. Once your child is permanently enrolled as an AmeriHealth member, you will be reimbursed for any prescriptions, minus your applicable copayment.
If you have additional questions, please go to the Contact Us page to find out where you can direct your questions.
