What if my Primary Care Provider (PCP) or Specialist is no longer a participating provider with Healthy Blue?
If your PCP or specialist is no longer part of the Healthy Blue network, we will mail a letter to notify you. If we know in advance that the provider is leaving the network, you will receive the letter at least 30 days before the effective date. If we learn the provider is leaving after the fact, we will send the letter as soon as possible. We will make a good faith effort to send notification within 15 days after we learn of the provider’s termination. If we are unable to send the letter within 15 days, you will receive it within 30 days.
A PCP can be a general practitioner, family physician, internal medicine physician, obstetrician/gynecologist or pediatrician. They provide your main care, coordinate and monitor referrals to specialist care, authorize hospital services and maintain your continuity of care.
Selecting a New PCP
- If you receive a letter notifying you that your PCP is no longer a Healthy Blue participating provider, call our Customer Care Center at 1-866-781-5094
(TTY 1-866-773-9634) to select a new one. We’re here Monday through Friday from 8 a.m. to 6 p.m.
- If you do not select a new PCP, we will assign one to you.
Selecting a New Specialist
If you receive a letter notifying you that your specialist is no longer a Healthy Blue participating provider, you will need to call your PCP as soon as possible. They will give you a referral to see a new specialist.
We are here to help if you need assistance selecting a new PCP or specialist. Contact our Customer Care Center at 1-866-781-5094 (TTY 1-866-773-9634) if you:
- Have questions
- Are undergoing an active course of treatment
- Are pregnant
- Are within six (6) weeks postpartum
- Have a child younger than three (3) years old who is receiving health care services from the terminating specialist