W1 - MercyCare HMO Plans
MercyCare HMO Benefits
The foundation of MercyCare Health Plan is to have each MercyCare member develop a caring, professional relationship with a Primary Care Physician (PCP) whom will coordinate and manage your medical care. All HMO plans require members to use the Provider network established except in the case of emergency care.
Choosing a Primary Care Physician (PCP)
A PCP is a doctor who practices in one or more of these fields: Family Medicine, Internal Medicine and Pediatrics. Each family member must select a doctor in one of these fields. Women may select an OB/GYN for routine gynecologic and obstetrical care, yet must still select a PCP for all other services. Please refer to our Provider Directory for a complete list of network PCPs.
MercyCare Health Plan has a comprehensive list of specialists to meet the health care needs of our members. You do not need a referral from your PCP to see any of our network specialists, but we encourage you to coordinate specialist care with your PCP.
Members who have a medical emergency within the MercyCare service area should, if possible, seek immediate attention at the nearest network provider. Members who have a medical emergency outside the MercyCare network should seek care at the nearest emergency facility. MercyCare should be notified within 48 hours, or as soon as possible.
No Claim Forms
When members use MercyCare providers, claim forms are not required and tedious paperwork is eliminated. Please make sure you show your identification card to the MercyCare provider so that you are assured a paperless visit.
If you would like a paper copy of your schedule or summary of benefits, please contact our Customer Service department at: