Medical Coverage - Maryland Physicians Care

If you are enrolled in Medicaid, you must renew once a year or you will lose your coverage.

Renew Now

Medical Coverage

Maryland Physicians Care offers medical coverage and health benefits that are close to home. This coverage includes access to primary and urgent care visits, pregnancy and new mother benefits, specialists care, pharmacy coverage, primary mental health services, vision and dental care* (including adults), and more. MPC’s participation in the HealthChoice program is available to Maryland Children’s Health Program or MCHP qualified recipients. Members can work within MPC’s network of doctors to find the care that is right for them.

*Dental Care through the Maryland Healthy Smiles Dental Program

Maryland Children’s Health Program

Maryland Children’s Health Program, or MCHP, is no-cost or low-cost health coverage for eligible children in Maryland. This program covers routine check-ups, immunizations, and dental care.

For more information, visit Maryland Children’s Health Program

Vision

Free vision care for adults (age 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 (age 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 MPC/Superior Vision at 1-800-428-8789 or visit MPC/Superior Vision.

Dental

Maryland Medicaid began providing dental coverage to adults in January 1, 2023. HealthChoice members will now be covered under the Maryland Healthy Smiles Dental Program (MHSDP). The MHSDP provides comprehensive dental services, including regular checkups and cleanings, x-rays, fillings, extractions, and more.

Questions about dental coverage?

For questions about your dental coverage, please call Healthy Smiles at 1-855-934-9812 or visit Healthy Smiles.

Behavioral / Mental / Substance Use Services

Taking care of your body is essential, but being healthy is more than physical health.

Mental health or substance use help is available. If you think you need help, please call:

  • Maryland’s Behavioral Health Provider, Optum Maryland, at 1-800-888-1965
    • Optum Maryland is open 24 hours a day, seven days a week. They have trained staff to handle your call and will help you get the mental health or substance use services you need. They provide emergent, urgent, and routine care.
  • MPC’s Member Services Hotline at 1-800-953-8854.
  • Your primary care physician (PCP).
    • When you talk to your PCP, they may refer you to Optum Maryland for additional care and services.

Primary Care

MPC’s provider directory is a list of physicians, hospitals, and other healthcare providers available to you. To start on your search, click on the link below.

Find a Provider

Can’t find the provider you are looking for? Call Maryland Physicians Care at 1-800-953-8854 for additional help.

Urgent Care Services and MyVirtualMPC

Members can be seen at urgent care centers. Please visit MPC’s website or call customer service for urgent care centers close to you.

MyVirtualMPC is your access to an emergency care doctor 24 hours, seven days a week. Download the MyVirtualMPC app or go to myvirtualmpc.com and see how easy it is to connect to a doctor! The app allows you to text, share images, or video chat with a doctor from your phone or computer.

Already Registered?
https://app.myvirtualmpc.com/sign_in

For emergency care, call 911 or go directly to a hospital emergency department if you are experiencing life-threatening conditions.

Mammograms and Annual Well Women Care

A mammogram is a special type of X-ray picture of the breast. It is used to find early signs of breast cancer. Regular mammograms are the best way to find cancer early. Finding cancer early means that there are more options and better treatments for it.

Learn more about mammograms and women preventative testing here.

Find out more about Women’s Health Services, including cervical cancer screenings, here.

Family Planning

MPC covers comprehensive family planning services such as:

  • Office visits for family planning and counseling
  • Laboratory tests, including pap smears
  • All FDA-approved contraceptive devices, methods, and supplies
  • Immediate postpartum insertion of IUDs
  • Oral contraceptives (Must allow a 12-month supply to be dispensed for refills)
  • Emergency contraceptives and condoms, without a prescription
  • Voluntary sterilization procedures (Sterilization procedures are not self-referred. Members must be 21 years of age or older and use an in-network provider or have authorization for out of network care.)

Seeing a Specialist

Your primary care physician (PCP) gives you most of your care. You should always go to your PCP first. Sometimes your PCP will send you to a specialist. Specialists work on specific parts of the body. For example, some specialists care for the skin (dermatologist). Some care for bones (orthopedists). Others care for the heart (cardiologists).

Your PCP and specialist will work together, so you get the care you need. Your PCP will tell you what to do if you need a specialist.

Medical Management

MPC focuses on keeping our members healthy. That is why the health programs and medical care that members receive are closely measured for quality and safety. This measurement is part of the Quality Improvement Program, a system that ensures members are receiving the care that meets their needs and improves their health.

Learn More

Notice

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.

Effective May 1, 2024, mandatory retail pharmacy copayments apply under certain circumstances. Please review these here.

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.

MPC Members: Sign up for Belong.

Belong is a FREE program that rewards MPC members with healthy prizes and valuable coupons!

Sign Up

Attention: Similac Powdered Formula Recall

Click Here to Read More