Using Your Primary Care Provider
After you have chosen your Primary Care Provider, you must call the PCP office first when you need care.
When You Make an Appointment
- Have your enrollee ID card and be ready to take notes.
- Call your PCP's office. You can find the phone number on the front of your Enrollee ID card or in the THP Provider Directory.
- Tell the office person that you are a Trusted Health Plan, District of Columbia Enrollee and that you want to make an appointment with your Doctor.
- Tell the person why you need an appointment.
- Write down the date and time of the appointment.
- Always take a list of any medications you are taking, including over-the-counter drugs.
If Your PCP's Office is Closed
If you cannot wait until the office is open, call the office number on the front of your ID card and leave a message with the person that answers.
You can also always speak to a nurse at the Nurse Call Line 24 hours a day; 7 days a week.(855) 872-1852
Out of Town Care
- Emergencies: If you have an emergency while traveling out of town, go to the nearest emergency room (ER), hospital, etc. to receive emergency treatment. At the emergency room, have the ER staff contact your PCP. Enrollee Services should also be contacted as soon as you are able.
- Prescriptions: Most prescriptions can be filled at national chain pharmacies. If you have any questions about a pharmacy or prescription check the Pharmacy Locator or contact the 24 hour pharmacy hotline at (855) 323-4588. You may also contact Enrollee Services (202) 821-1100 or (855) 872-1852 during business hours.
- Routine and Specialty Care: If you are out of town and need routine or specialist care, you must call THP Enrollee Services for approval. Any services provided without prior approval from THP will have to be paid by you.