1.  How Can I Change My PMP?

2.  What Is A Network?

3.  How Do I File A Complaint?

4.  Can I Choose A Doctor For My Baby Before The Birth?

5.  Do I Have To Get My Doctor To Approve All Health Care Services?

6.  What If I Need Medical Attention And My Doctor's Office Is Closed?

7.  How Can I Request A New Card?

8.  How Can I Change My Address?

9.  What Do I Do If I Need To Miss Or Missed An Appointment?

1.  How Can I Change My PMP?

In order to change your PMP, please call your local Benefit Advocate or the In-house Benefit Advocates and Helpline can assist you at 1-800-889-9949 (M-F 8:00am-7:00pm and Sat. 8:00am-1:00pm).

2.  What Is A Network?

A network is a group of healthcare providers including primary care doctors, specialists, home healthcare providers, pharmacies, therapists, and so on. Each doctor on this list is enrolled in one of these networks, sometimes called a "Plan". When you choose a doctor, then you become a member of that Plan. This means you can only use the providers in the Plan. It is important for you to know which Hoosier Healthwise network you and your doctor are in. For most health care services, you must use the health care providers who are in your plan's network.

3.  How Do I File A Complaint?

If you have a complaint or grievance regarding your PMP, you need to call the network in which you are enrolled with that PMP.   If you do not know which network you are in, please call local Benefit Advocate or the In-house Benefit Advocates and Helpline can assist you at 1-800-889-9949 (M-F 8:00am-7:00pm and Sat. 8:00am-1:00pm).  The member services phone numbers for all networks are listed below:

4.  Can I Choose A Doctor For My Baby Before The Birth?

Yes, you need to choose a doctor for your baby before the baby is born. You will need to choose a doctor that is in the same network that you are in.  If you do not choose before the baby is born, you may not have a chance afterwards before the baby needs care. If you’re not sure which doctor you’d like, you can take the list home with you and then decide.

5.  Do I Have To Get My Doctor To Approve All Health Care Services?

There are some types of services that you can go to on your own without seeing your personal doctor first. These include basic eye care (eye surgeries require a doctor’s approval), dental services, foot care, chiropractic services, mental health services, and family planning.  However, some services need a referral from your doctor, like when you need to go to the hospital or need to see a specialist.

6.  What If I Need Medical Attention And My Doctor's Office Is Closed?

Make sure you get the number where you can reach your doctor after hours for health care services. A qualified medical professional will be available to you 24 hours a day to give you medical advice and tell you what you should do in each individual situation. Never go to the emergency room unless you have a true emergency. True emergencies are when a delay in treatment would result in lasting injury or death.  Some examples are chest pain, broken bones, bad bleeding that can not be stopped, or drug overdoses. 

7.  How Can I Request A New Card?
 

If you need to request a new card, please call your local Benefit Advocate or the In-house Benefit Advocates and Helpline can assist you at 1-800-889-9949 (M-F 8:00am-7:00pm and Sat. 8:00am-1:00pm).

  8.  How Can I Change My Address?

If you need to change your address, please call your local Benefit Advocate or the In-house Benefit Advocates and Helpline can assist you at 1-800-889-9949 (M-F 8:00am-7:00pm and Sat. 8:00am-1:00pm). 

9.  What Do I Do If I Need To Miss Or Missed An Appointment?

If you need to miss a scheduled appointment with a provider, you need to call the doctor’s office as far in advance as possible.  Most offices consider 24-48 hours notice as acceptable.  If you remember that you have missed an appointment after the appointment, you should call your doctor’s office to apologize, explain why the appointment was missed, and reschedule.