Getting Into CareYour health is important.
As soon as possible, pick a primary care doctor (PCP). Your PCP is your family doctor, or the doctor you regularly see. This is your medical home. Your PCP takes care of your health care and will help you get care from other health care providers when needed. This is called “coordination of care.” Coordination of care makes sure you get the care you need when you need it. This is why having a medical home is so important.
You can choose the same PCP for your whole family or you can have a different PCP for each family member. There are different kinds of practitioners who can be PCPs, including:
- Family Practice and General Practice doctors, who treat adults and children,
- Internal Medicine doctors or Internists, who treat members older than the age of 18,
- Pediatricians, who treat children from birth to age 21, or
- Certified Registered Nurse Practitioners (Nurse Practitioners). Under the guidance of a doctor, the Nurse Practitioner can be your PCP.
The State of Maryland issues an EPSDT certification to primary care providers (PCPs) who are trained to follow the EPSDT (Early, Periodic, Screening, Diagnostic and Treatment) standards during well visits. CareFirst Community Health Plan Maryland (CareFirst CHPMD) encourages all members to select EPSDT certified PCPs to care for members who are less than 21 years old. If you select a non-certified EPSDT provider, CareFirst CHPMD will notify you about your options of keeping that doctor or changing to a certified provider. Our Member Services Department can tell you which PCPs are EPSDT certified.
Choose a PCP and see the addresses of all our doctors, or call our Member Services Department at 1-410-779-9369 or 1-800-730-8530, and they will help you find a doctor near you. TTY users should dial 711. When you get the doctor’s telephone number, just call to make an appointment. The sooner you see your PCP, the better.
- Referral to a Specialist or Specialty Care
- After Hours Care
- Urgent Care
- Emergency Care
- Out-of-Area Coverage
Some examples are:
- Ear infections
- Urinary tract infections
- Coughs and congestion
- Sore throats
- Insect bites
Members may go to their doctor or a CareFirst Community Health Plan Maryland (CareFirst CHPMD) network Urgent Care Center.
What is an emergency? An emergency is when not seeing a provider right away to get care could result in death or very serious bodily harm. The problem is so severe that someone with an average knowledge of health can tell the problem may be life threatening or cause serious damage to your body (or, with respect to pregnant women, the health of the woman or her unborn child).
Some examples of problems that are most likely an emergency are:
- Trouble breathing
- Chest pains
- Loss of consciousness
- Very bad bleeding
- Very bad burns
- Severe pain
You should call your Primary Care Provider within 24 hours after you visit the emergency room. If you cannot call, have someone else call for you. Your Primary Care Provider will provide or arrange any follow-up care you may need.