HMO Frequently Asked Questions
I've heard I'll need a personal care physician (PCP). What does that mean?
HMO members are required to select a HAP-affiliated personal care physician (PCP) to manage your health care. Your PCP will guide you through the medical system and coordinate your medical care among various specialists.
How can I find out if my physician is affiliated with HAP?
We have over 2,000 PCPs affiliated with us so there is a good chance your physician is already with us! To make sure your physician is HAP-affiliated; check out our PCP Search & Select application and enter the physician's name. If you don't see your physician listed, contact us about having him/her join the HAP network.
How do I see a specialist?
When specialty services are medically necessary, your PCP will direct you to a specialist. For more information on PCP Directed Care>>
Routine OB/GYN care does not require PCP direction. For more information on OB/GYN care>>
What's a medical center or physician's hospital affiliation?
When you join HAP and select your PCP, you become part of that PCP's medical center/hospital affiliation. A medical center is made up of many physicians (PCPs and specialists) who are under one roof, a one-stop shop for services. Hopsital affiliation describes providers grouped together to serve you. These providers work in private offices and may also include a hospital that is linked in. Both terms refer to the team of physicians that you will seek all care from, routine and specialty.
What about emergency services?
Never fear, HAP is here. You have worldwide coverage for emergency services so around town or around the country you are covered. You don't need to call us, just go to the nearest emergency room or call 911 for assistance. If you are admitted to the hospital after an emergency, you'll need to contact us at the number on your ID card.
Will I have to submit claims for any services I receive?
As a HMO member, you don't have to submit claim forms for services provided by affiliated providers. For example, if you see your physician for an annual checkup, your physician will bill us and you would just pay your copay. If, however, you have an emergency while out of our service area, you may be required to pay for services up-front and submit a claim for reimbursement. If this happens, you would simply mail a copy of the claim to us.
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