WEB-MD-0002-13 Member Website Update - FAQs - Amerigroup

Frequently Asked Questions
Who is Amerigroup Community Care?
Amerigroup Community Care is a health plan in Maryland. Since 1999, it has offered health care coverage to
people eligible for HealthChoice through Medicaid. HealthChoice is a program of the Maryland Department
of Health and Mental Hygiene.
Is my family eligible?
HealthChoice
Medicaid helps low-income individuals and families get health care coverage. Amerigroup Community Care is
a health plan that offers coverage at no cost to you. To qualify, you must be one of the following:
A resident of Maryland
A U.S. citizen
A qualified alien
You must also be one of the following:
Under 65 years old
A person with disabilities
A person who is blind
Under 21 years old
Caring for a related child in your home
Pregnant
A parent of an unmarried child under 21
The following people automatically get Medicaid:
People who get money through Supplemental Security Income (SSI)
People who get Temporary Cash Assistance (TCA)
Find out if you’re eligible at www.marylandSAIL.org. Contact the local Department of Social Services
in the city or county where you live for information.
Maryland Children's Health Program
Amerigroup Community Care is a health plan that offers coverage at low cost or no cost to you through the
Maryland Children’s Health Program (MCHP). MCHP provides health care at no cost to:
Children under age 19 who aren’t eligible for Medicaid and whose income is at or below 200% of the
federal poverty level (FPL)
Pregnant women of any age whose countable income is at or below 250% FPL
Uninsured persons
In some cases, insured persons*
*It’s best to apply and let the case manager assigned to your application determine whether your health
insurance will affect your eligibility for MCHP.

If you or your children aren’t eligible for MCHP, your children may still qualify for MCHP Premium. With
MCHP Premium, you pay a small copay for health coverage for your children. Find out more about income
limits here.
Through MCHP or MCHP Premium, Amerigroup offers preventive care, great benefits and special programs
that can help keep your family healthy.
Medical Assistance for Families
On July 1, 2008, the State expanded eligibility requirements with its new Medical Assistance for Families
program. If you didn’t previously qualify for Medicaid, you may now be eligible for coverage in this program.
A family of three who makes up to $21,495 a year is now eligible.
Medical Assistance for Families
Household Size Children (MCHP) Annual Income Limit for Families
1 $21,780 $12,633
2 $29,420 $17,064
3 $37,060 $21,495
4 $44,700 $25,926
5 $52,340 $30,358
6 $59,980 $34,789
Each person add: $7,640 $4,432
You pay: $0 $0
Find out if you’re eligible at www.marylandSAIL.org. Contact the local Department of Social Services in the
city or county where you live for information.
What does it cost?
There are no costs to HealthChoice and MCHP members for medical services*. Pregnant women and
members under 21 pay nothing for prescriptions. Members 21 and over pay:
$3 for brand name drugs
$1 for generic drugs
*Costs apply for MCHP Premium members.
How do I enroll in Amerigroup?
If you’re eligible for HealthChoice or MCHP, you’ll be sent materials so you can choose Amerigroup. You may
enroll by mail, telephone or in person. To find out more, call the HealthChoice Enrollment Line at
1-800-977-7388.
I just lost my benefits. How do I re-enroll?
Call your local Department of Social Services (DSS) office, and they can answer your questions about reenrolling.
Here’s a list of Department of Social Services locations. You can also call the Department of Human
Resources (DHR) toll free at 1-800-332-6347.

Can I keep the same doctor?
All Amerigroup members must have a family doctor, also called a Primary Care Provider (PCP). You can keep
the same PCP if he or she is in the Amerigroup network.
Can I see a doctor outside of the Amerigroup network?
You can see any provider or hospital in case of an emergency. You should check with Amerigroup before
seeing any doctor who is not your PCP or is outside of the Amerigroup network.
How do I switch PCPs?
If you need to change your PCP, you may pick another PCP from our network at any time. To find a provider
in your area, you can search our online provider directory. You can also change your PCP at
www.myamerigroup.com/MD. Or call Member Services for help choosing a new PCP. If you change your PCP,
the change will start right away. Once your PCP has been changed, you’ll get a new ID card in the mail within
10 business days.
Will I lose my benefits if I switch PCPs?
You won’t lose any health care benefits as long as that PCP is in the Amerigroup network.
Can my children and I have different PCPs?
Yes.
Do I need a referral to see a specialist?
You‘ll go to your PCP for most of your health care, or your PCP will send you to a specialist in the Amerigroup
network. You’ll find more information in our member handbook.
Are prescription drugs covered?
You can get prescriptions and medicines from approved pharmacies in the Amerigroup network. You’ll find a
list of network pharmacies in our online provider directory.
You should always show your Amerigroup member ID card when you have a prescription filled.
Members under 21 and pregnant women can get unlimited prescriptions without a copay. Members 21 and
over have a $3 copay for brand name drugs and $1 copay for generic drugs.
Where can I get more information about my new benefits?
To learn more, call 1-800-600-4441 (TTY 1-800-855-2880) or see your member handbook.
How can I get a new ID card, handbook and directory?
Visit www.myamerigroup.com or call Member Services at 1-800-600-4441 (TTY 1-800-855-2880).
If I don’t have my card, can I still go to the doctor?
If you don’t have your member ID card, tell your doctor’s office you are with Amerigroup. They should be
able to help you.

What is utilization review and how can I get more information about utilization
review for the medical services I received before, during and after a hospital stay?
Utilization review is a process for monitoring the use, delivery, and cost-effectiveness of medical treatment
and services patients receive while in the hospital. To learn more, call Member Services at 1-800-600-4441.
How can I find out if I qualify for case management services?
To learn more, call member services at 1-800-600-4441.