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Frequently asked questions

How do you get more information on your primary care practitioner (PCP)?

You can always call Member Services at 1-888-991-7200, if you have any questions about your doctor.

How can I choose or change my PCP or other health care provider?

To choose or change your PCP or other health care provider, go to Find a Provider. You can find a list of PCPs and providers that are in the AmeriHealth Caritas network. Then call Member Services at 1-888-991-7200 to ask for the change.

How do I get a list of all participating providers?

Call Member Services at 1-888-991-7200, and ask that a list be sent to you.

What services does AmeriHealth Caritas cover?

Refer to the quick reference guide (PDF) showing our list of services and benefits.

What do I do if I get a bill from a health care provider?

As an AmeriHealth Caritas member, you are not responsible for paying for medically needed, covered services. You may, however, be responsible for co-payments.

You can be billed for health care services if one of these situations happens to you:

  • A service is provided without prior authorization in cases when prior authorization is required.
  • A service is provided by a provider who is not in the AmeriHealth Caritas network and prior authorization was not given to see the provider.
  • A service provided is not covered by AmeriHealth Caritas and your health care provider told you before you received the service.

Your health care provider can also bill you for co-pays that were not paid at the time you received the service.

If you get a bill from a health care provider, you should call the health care provider listed on the bill and make sure they have all your insurance information. If you still feel you were billed in error, you should call AmeriHealth Caritas Member Services.

Who can I call if I have special needs?

If you or your family has a special need that needs attention, please call the Special Needs Unit at 1-800-684-5503. We are here to help you.

How do I know AmeriHealth Caritas is providing me with quality care?

AmeriHealth Caritas works to give you the best quality health care. Take a look at our quality improvement (QI) program to learn more.

How can I make suggestions about improving my health care services?

Please call Member Services at 1-888-991-7200 and ask for a representative.