If You . . .

Then . . .

Have any questions

Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free)

Need to choose a PCP

Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free) for assistance.  We can send you a copy of the Directory or you can go to our website (www.procarehp.com).  The Provider Directory lists:

•          Names of PCPs, Specialists, Hospitals and Ancillary (i.e., drug store, medical suppliers, home health care)

•          Addresses

•          Days and hours open

•          Phone numbers

•          Language spoken

•          Any hospital affiliation

Need to see a OB/GYN

•          You may see an OB/GYN for annual well-woman examinations and routine OB/GYN care without a referral from your PCP

Need to request a change in my PCP

Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free).  Remember:

•          Your assignment to a new PCP will be effective on the first day of the following month if requested by the 15^th of the current month

•          You should verify the effective date of change with us when you request the change

•          While the change is being made, you should continue to see your current PCP

Need to make an appointment

•          Call your PCP’s office during regular business hours to set up an appointment

•          Tell them that you are a Pro Care member

•          Tell them why you need to see your PCP

•          Call your PCP early in the morning for an appointment for same day

•          Leave a message if your reach their answering machine

Need to see a Specialist

Ask for a referral from your PCP who will  give it to the specialist

Need a referral or authorization

Please remember: 

•          You must need the medical care

•          Your PCP must approve your visit to a specialist or other provider

•          You must have a referral from your PCP

•          A referral from your PCP is also necessary for all follow-up care after emergency treatment

•          Your PCP will arrange for a second opinion if it is needed

Are out of town and get sick or hurt

•          If it is an emergency, you may go to the nearest hospital without a referral

•          Call your PCP for a referral for all other out of area medical care needs  

•          Call us at 1-313-267-0300 (local) or 1-877-255-3055 (toll free) if your PCP is not available

Have an emergency (it’s so serious or life threatening that delay might cause death or permanent harm)

•          Go to the nearest emergency room or call 9-1-1

•          You do not have to call us or your PCP

Need transportation

•           Call 9-1-1 if you have an emergency

•          If you need non-emergency transportation such as a ride to get to your doctor’s appointment, please call us at 1-313-267-0300 (local) or 1-877-255-3055 (toll free).  We will need:

o    to ask some questions

o    arrange a time to schedule your ride

Need a prescription filled

•          Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free) if you:

•          Have any questions about your drug coverage or

•          Need to know the Pharmacy nearest to you

•    Want a copy of the:

•  list of covered and non-covered drugs or

•  Provider Directory

Need a list of providers for eye care

•    Call us at 1-313-267-0300 (local) or 1-877-255-3055 (toll free). We cover routine eye test, lenses and frames.  You can:

•    Visit any of the locations in the Provider Directory to get your vision services and check-ups

Need Mental Health Care

•          Talk to your PCP or call us at 1-313-267-0300 (local) or 1-877-255-3055 (toll free). We cover up to 20 visits per year for outpatient mental health services

•          Go to the nearest emergency room if you have a mental health emergency

If you think you are pregnant

•          Call your PCP right away and have a pregnancy test

When you are sure you are going to have a baby:

•          Your PCP can help you choose a maternity provider

•          It is important for the health of your baby to see your maternity provider as early as possible.  Don’t delay!  

Have a baby

•          Call your DHS caseworker to sign up your newborn baby in the Medicaid program and have your baby enrolled with us

•          Get a new ID card for your baby

Need to report changes in your family size, name, address or telephone #

Report the changes by calling us at 313-267-0300 (local) or 1-877-255-3055 (toll free):

•          Changes in your family size must also be reported to DHS and to us

Need to file a grievance or appeal

Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free) or file a complaint directly with the State of Michigan within 90 days of denial, reduction or termination of a service. 

Suspect Fraud and Abuse

Call us at 313-267-0300 (local) or 1-877-255-3055 (toll free)

Want a family member or friend to ask Pro Care for your personal health information

You must give us written permission

Need to look something up on the Website

Go to our website (www.procarehp.com)

Have your ID stolen

Call us immediately at 313-267-0300 or 1-877-255-3055 (toll free)

Need help (diabetes, to quit smoking, asthma)

Call us at 313-267-0300 or 1-877-255-3055 (toll free) and we will provide help