Frequently Asked Questions (FAQs)

The copays below apply to members who are in the Health Benefits for Immigrant Adults and Seniors program.

• Nonemergency inpatient hospitalizations: Up to $250 copay
• Ambulatory Surgical Centers and Outpatient Services: Up to 10% of the Medicaid payment. The amount members can be charged will vary. It depends on the service. Providers will tell members what they will be charged before they provide service.

Yes, if they are listed in the Preferred Drug List (PDL). The PDL is a list showing the drugs that are covered by BCCHP. Restrictions may apply to some drugs. Check Drug Coverage for information.

Simply log into your BAM account to request one or print a temporary ID Card. You may also call Member Services at 1-877-860-2837 (TTY/TDD: 711) to get a new card. The call is free. It may take up to two weeks to get a new card.

If you need to update or change your address, please contact the State (the Department of Healthcare and Family Services). To change your address, call HFS at 1-877-912-8880, Monday to Friday, from 8 a.m. to 6 p.m. The call is free. BCCHP can only receive changes on your address directly from HFS.

You must choose a PCP when you join the plan. There's also a wide selection of specialists to choose from. You can use the Provider Finder^® to find a doctor or hospital online. You can also check providers listed in the Provider Directory. Call Member Services at 1-877-860-2837 (TTY/TDD: 711) for help to find a provider.

A provider that is contracted with BCCHP to provide services to members. They are also called a participating provider. BCCHP does not pay for services from out-of-network providers unless you receive prior authorization for those services.

Your PCP coordinates all your health care. If you would like to change your PCP, please call Member Services. There is no limit on how many times you can change your PCP. We can be reached at 1-877-860-2837 (TTY/TDD: 711). The call is free.

• If you ask to change your PCP anytime during the month, you may go to your new PCP within 30 days of getting your request for change.
• You’ll get a new member ID card with your PCP’s name and contact details on it. You can go to your newly assigned PCP prior to receiving your new ID card.
• If your PCP is not-in-network or is no longer accepting patients, your request may not be approved by BCCHP.
   

Certain services must have approval from BCCHP. This approval is called a "prior authorization." If approval is not obtained, those services will not be covered. Check your Blue Kit Member Handbook for a list of services that need approval. To ask for approval, you or your provider must call BCCHP. Providers know which services need prior approval. They can handle the details for you.

Yes. You can get a second opinion for any procedure or treatment. Your doctor can recommend a specialist. You or your doctor can call Member Services for help.

No. However, make sure the specialist is in the BCCHP network. Also, confirm that the services are covered before you make an appointment. If not, you will be responsible for costs of services not covered. Even if you don’t need a referral for some services with specialists, you may need prior approval. Ask your PCP. They are best to coordinate your medical care, including visits to specialists.

An emergency is a sudden medical condition with severe symptoms, including intense pain. Without immediate medical help your health and life could be in danger.

Services received in an emergency room (ER) or other trauma centers must meet the definition of “emergency” to be covered. You do not need prior approval for emergency services. Care received in a doctor’s office or urgent care facility are not considered emergencies. Check your Blue Kit Member Handbook for guidelines on emergency care coverage.

BCCHP wants to make sure you get proper care in an emergency. Here’s what you need to do:

1. Call “911” or other community emergency resources for assistance in emergency situations.
2. Go to the nearest hospital or trauma center.
3. Please call Member Services within 48 hours of the admission. We can be reached at 1-877-860-2837 (TTY/TDD: 711). The call is free.
4. Call your PCP as soon as reasonably possible after getting emergency treatment. They will help arrange for follow-up care.
    

If you have an unexpected medical situation, call the Nurseline at 1-888-343-2697. A nurse can help you decide if you should call your doctor, visit the ER or urgent care, or treat the problem at home.

You can get a ride to a provider’s appointment, pharmacy or a BCCHP sponsored event for free. Just make sure to request your ride at least 3 days in advance. BCCHP does not cover rides for non-medical reasons, except to BCCHP sponsored events. Get more details on how to schedule a ride on the Transportation page.

A parent or caregiver may ride with children or members with special needs. If you are a member who is a single caregiver, and you have more than one minor child in your care, you can ask Member Services to approve transportation for additional minor children. Caregivers or other children must be approved by BCCHP when the ride is scheduled.

Yes. You may pre-schedule a return ride if you know what time you will be done. If you pre-schedule your return ride, the driver should come within 30 minutes.

If you do not have a pre-scheduled pick up time, call ModivCare at 1-877-831-3148 when you are done with your visit. The driver should come within an hour of the call.