Getting care with your PCP
Once you have picked a PCP, it is important to call your PCP first when you need care. Your PCP is there to help you get healthy and stay healthy. With your PCP, you can work together as a team to get the care and services you need. It’s important to know and talk with your PCP so your health stays on the right path.
Do you need to make an appointment?
- Have your member ID card, a pen and paper for notes.
- Call your PCP’s office. Look for your PCP's phone number on the front of your member ID card. You can also find it in our provider directory.
- Tell the person who answers that you are an AmeriHealth Caritas District of Columbia (DC) member. Tell them you want to make an appointment with your PCP.
- Tell the person why you need an appointment.
- Write down the time and date of your appointment.
- Tell your PCP if you have any pre-existing conditions.
If you need help making an appointment, call Member Services at 1-202-408-4720 or toll-free at 1-800-408-7511.
Getting care when your PCP office is closed
If you need to speak to your PCP when the office is closed, call your PCP’s office and leave a message with the person who answers the phone when the office is closed. Or, if you want general information about a health care topic, you can email our nurses. They will call you back within 24 hours.
If you have a specific health-related question, please call the Nurse Call Line at 1-877-759-6279 (TTY: 1-202-216-9885 or 1-800-570-1190).
When you are out of town
If you need to see a doctor or get medicine when you are out of town, for:
- Emergency care: Go to the nearest emergency room (ER), hospital or other appropriate setting where you can receive emergency treatment. You have the right to use any hospital or other setting to receive emergency care. If you go to the emergency room, you should ask the ER staff to call your PCP. If you go to the emergency room, you should call Member Services as soon as you can.
- Prescriptions: Call our Pharmacy Member Services department at 888-452-3647. You may be able to get your prescription filled at a national chain pharmacy.
- Urgent care: Call your PCP. If your PCP's office is closed, call the Nurse Call Line at 877-759-6279. A nurse will help you decide if you need to go to the doctor right away. The nurse can tell you how to get care. You do not have to go to the emergency room or use an ambulance for routine or urgent care.
- Routine and specialty care: You must call us and ask if we will pay for you to see a doctor or other provider when you are out of town because doctors who are not in the District of Columbia are not a part of AmeriHealth DC. If AmeriHealth DC does not say it is okay before you get the care, you will have to pay for the care. The only exception is emergency room care. If you have an emergency, you should visit the nearest ER.