New Member or Getting Started?

Now that I have joined my HMO plan, what should I do to make certain that my medical care will be covered (paid for)?

HMO Plans operate on the basis that a Primary Care Physician provides, coordinates, and/or directs all of your medical care. It is necessary that each enrolled family member becomes established with a Primary Care Physician as soon as possible after the date of enrollment.

Which physicians serve as primary care physicians?

Adults may choose either an Internist or a Family Practitioner as their Primary Care Physician. Children may have either a Family Practitioner or a Pediatrician as their Primary Care Physician.

If I am already a patient of a primary care physician on the IHP panel (list) can he/she continue to serve as my primary care physician that I am a member of this HMO?

Yes, if your current physician is an Internist, Family Practitioner, or a Pediatrician on the IHP PCP list they may continue to serve as your primary physician.

Do I need to show my HMO membership identification card in order to receive HMO coverage?

Yes. You need to show your Membership Identification Card each time you see your primary care physician or any physician to whom you have been referred. Your membership card should always be presented when receiving care in any facility, e.g.: Urgent, Care, Hospital, Ambulatory Center, Home Health Agency, Durable Medical Equipment provider, Pharmacy, etc.

If I have questions about eligibility or membership identification cards, who should I call?

Telephone your HMO Membership Services Department regarding eligibility or membership identification cards at the number listed on the back of your Identification Card.

Is it the responsibility of IHP or my physician to understand my benefit plan?

It is your responsibility to know your benefits! You have received a Subscriber Benefit Plan Booklet from your HMO. It is important that you read it and become familiar with what is covered and what is not covered. If you are unsure of your benefits, speak with your employer or your HMO directly. IHP’s Customer Service may be reached at 630-942-7950 to assist you with benefit questions.

How do I notify IHP of an address or telephone change?

You may submit an address or telephone change to IHP by mailing or faxing a completed Change of Information Form or by calling a Customer Service Representative at 630-942-7950. Please note that all other changes, such as name or date of birth corrections, should be submitted directly to your health plan.