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 (dermatologists). 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. MPC will pay both your PCP and your specialist.
Your Medical Team
A PCP is a short name for a primary care provider. A Primary Care Provider (PCP) is the doctor or nurse practitioner who manages your medical care.
A specialist is a doctor trained to treat a specific medical condition, like the heart, bones, or brain.
Specialty care refers to the health care services given by a specialist. Some special health care needs may require that you see a specialist as part of your primary care (health care services).
Help Is Here!
If you have any questions, please call Maryland Physicians Care (MPC)’s Member Services department at 1‑800‑953‑8854.
Your PCP will set up or give you all of the covered services you need. Make sure you talk to your PCP about any health problem you have. It is important to have a good relationship with your PCP. That way, your provider gets to know you and your medical history.
Always follow your PCP’s advice about your health care and check with your PCP before getting medical care or other providers’ services. Your PCP can also refer you to a specialist for specialty care services when necessary.
Selecting or Changing Providers
When you join MPC, you can choose the PCP you want for yourself and your eligible family members. You must select a PCP who participates with MPC. You can use our Find a Provider search tool to find a PCP in your area.
Note: You do not have to choose the same PCP for every family member.
If you do not choose a PCP, MPC will select one for you. If you want a different PCP than the one assigned, please call MPC’s Member Services department at 1-800-953-8854 to change your PCP.
MPCs Member Services can also help you if you need:
- Help choosing a PCP
- Information about the provider assigned
- Information about other providers on our plan
- Care and cannot reach your PCP
How Do I Change My PCP?
Your PCP is an important part of your health care team. We want you and your PCP to work together. If you want to change your PCP, you can call our Member Services department at 1-800-953-8854 to request a change. You will get a new ID card within ten days of the requested change date.
You must work with your PCP. Your PCP keeps records of all your health care services. Medical decisions about your health are based on your health history. MPC monitors the number of PCP changes a member requests to determine if assistance is needed to select a PCP that the member can build a long relationship with.