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Your Part—Step by Step

STEP 1: Complete and Submit Your Member Qualifcation Form

Schedule an appointment with your HAP-contracted PCP to review and complete the Member Qualifcation Form . Your form will be used to identify if you’ve reached specifc wellness targets.

If you don’t have a PCP

To select a PCP, simply click or call. • Log in at hap.org

• Call our toll-free automated system at (877) 427-3678 . (Please have the PCP’s Physician Code on hand when you call. The code can be found in the Provider Directory or at hap.org .)

• Call and speak with a HAP PCP Selection Specialist toll free at (888) PIC-A-PCP (888-742-2727)

Important! Incomplete forms will not be accepted. It is the member’s responsibility to be sure the form is completed in full and received by HAP during the frst 90 days of coverage in order to qualify for the Enhanced plan. Please keep a copy for your records.

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