Understanding your benefits
As a member of Maryland Physicians Care, your health benefits are available at no cost to you. A detailed list of benefits can be found in the HealthChoice Member Handbook.
Call Member Services with questions at 1-800-953-8854.
Free prescriptions and over-the-counter medications.
Free vision care for adults (21 and older)
- One eye exam every year
- One set of glasses OR contact lenses every two years
- One pair of lenses every year (when needed)
Free vision care for children (20 and under)
- One eye exam and set of glasses every year
- One set of contact lenses (when medically necessary)
Questions about vision coverage?
For questions about your vision coverage, please call Superior Vision at 1-800-428-8789 or visit Superior Vision.
Dental care for adults (21 and older)
- Free exams and cleanings two times a year
- Limited X-rays once a year
- Limited cavity fillings (with some cost to you)
- Simple and medically necessary emergent extraction (with some cost to you)
- 20% discount on non-covered dental services
Dental care for children under the age of 21 and pregnant women
The Healthy Smiles program offers dental care to keep children and pregnant women healthy.
Questions about dental coverage?
For questions about your adult dental coverage (age 21 and older), please call DentaQuest at 1-800-685-1150 or visit DentaQuest.
For questions about your dental coverage for children under the age of 21 and pregnant women, please call Healthy Smiles at 1-855-934-9812 or visit Healthy Smiles.
How do I get mental health services?
Taking care of your body is important. But being healthy is about more than physical health.
If you think you have mental health problems and need help, call the The State's Mental Health Provider (Optum Maryland) at 1-800-888-1965, call our Member Services hotline or talk to your primary care physician (PCP).
Your PCP will ask you questions to help decide if you need mental health treatment. Your PCP may decide that he or she can help by giving you some medications for your problem and you don’t need to go to the The State's Mental Health Provider (Optum Maryland). Or your PCP may refer you to The State's Mental Health Provider (Optum Maryland).
If you call The State's Mental Health Provider (Optum Maryland) yourself, the toll‑free help line is open 24 hours a day, 7 days a week and is run by mental health staff called care managers. Care managers are trained to handle your call and will help you get the services you need.
If you have received mental health care services in the past, and would like to see the same provider, let the care manager know and every effort will be made to get you to the same provider. If The State's Mental Health Provider (Optum Maryland) finds that you do not need specialty mental health services, your PCP (with your permission) will be informed so that you can receive any needed follow‑up care.
The State's Mental Health Provider (Optum Maryland) Timeframes
How quickly you are seen for specialty mental health care will depend on the type of treatment you need. Here is what you can generally expect:
- Emergency. If the care manager finds that your problem is an emergency, you will be seen the same day, usually within 4 hours.
- Urgent. If your problem is not an emergency but you still have an urgent need to see a mental health specialist, you will be seen within 24 hours.
- Scheduled. If you are not having a crisis but still need to see someone for an evaluation, an appointment for specialty care will be scheduled within 10 work days.
Members have access to a doctor from 9 am - 9 am every day of the year using the MyVirtualMPC app. A virtual visit can take place from anywhere and gets you the answers you need after hours without having to visit an emergency room.
Visit www.myvirtualmpc.com to register.
- State provided cell phone to eligible households
- 350 free monthly minutes
- Unlimited text messaging
More benefits at NO COST to you!
- Routine primary care provider visits and physical exams
- Urgent and emergency care
- Immunizations for children
- Primary mental health services
- Substance abuse treatment and counseling
- Start Smart for Your Baby program for pregnant women and new moms
- Free Pacify app for pregnant and new moms
- Case managers for health conditions like asthma, diabetes and high blood pressure
- Disease management educational programs
- Transportation assistance
MPC members have no financial liability (i.e. co-insurance, deductibles, charges in excess of allowable amounts, differences in cost between in network care and out-of-network care or costs that vary for the formulary) for covered services during valid HealthChoice enrollment assigned to Maryland Physicians Care.
To find out more about what's covered, download the HealthChoice Member Handbook or call the Maryland Physicians Care HealthChoice Member Services Department toll-free at 1-800-953-8854.