Getting Into Care

Your health is important.

As soon as possible, pick a primary care doctor (PCP). Your PCP is your family doctor, or the doctor you regularly see. This is your medical home.  Your PCP takes care of your health care and will help you get care from other health care providers when needed. This is called “coordination of care.” Coordination of care makes sure you get the care you need when you need it. This is why having a medical home is so important.

You can choose the same PCP for your whole family or you can have a different PCP for each family member. There are different kinds of practitioners who can be PCPs, including:

  • Family Practice and General Practice doctors, who treat adults and children,
  • Internal Medicine doctors or Internists, who treat members older than the age of 18,
  • Pediatricians, who treat children from birth to age 21, or
  • Certified Registered Nurse Practitioners (Nurse Practitioners). Under the guidance of a doctor, the Nurse Practitioner can be your PCP.

The State of Maryland issues an EPSDT certification to primary care providers (PCPs) who are trained to follow the EPSDT (Early, Periodic, Screening, Diagnostic and Treatment) standards during well visits.  UM Health Partners encourages all members to select EPSDT certified PCPs to care for members who are less than 21 years old.     If you select a non-certified EPSDT provider, UM Health Partners will notify you about your options of keeping that doctor or changing to a certified provider.  Our Member Services Department can tell you which PCPs are EPSDT certified.

Click here to choose a PCP and see the addresses of all our doctors, or call our Member Services Department at 1-410-779-9369 or 1-800-730-8530, and they will help you find a doctor near you. TTY users should dial 711.  When you get the doctor’s telephone number, just call to make an appointment. The sooner you see your PCP, the better.


Continuity of Care Notice

If you think you need specialty care, please call your Primary Care Provider. You can also call UM Health Partners’ Member Services Department at 1-410-779-9369 or 1-800-730-8530. TTY users should call 711. We can help you get the care you need.
Because you never know when you will need medical care, your Primary Care Provider is available 24 hours a day. If you call the office when it is closed, leave a message with your name and a telephone number where you can be reached. You may also contact UM Health Partners’ after hours Case Manager by calling 1-410-779-9369 or 1-800-730-8530. TTY users can call 711.
There are illnesses and injuries that can turn into an emergency if they are not treated within 48 hours. These conditions may require urgent care.

 

Some examples are:

  • Ear infections
  • Urinary tract infections
  • Coughs and congestion
  • Diarrhea
  • Sore throats
  • Insect bites
  • Rashes

Members may go to their doctor or a UM Health Partners network Urgent Care Center.

If you have a medical emergency, you do not need a referral from your PCP to go to the emergency room (ER). If you think you need emergency care, call 911 or go to the nearest emergency room right away. If you are not sure if you should go to the ER, call your PCP for advice. Except for emergencies and urgently needed care when you are traveling outside the service area, UM Health Partners will not pay for services you receive from non-UM Health Partners doctors and facilities.

What is an emergency? An emergency is when not seeing a provider right away to get care could result in death or very serious bodily harm. The problem is so severe that someone with an average knowledge of health can tell the problem may be life threatening or cause serious damage to your body (or, with respect to pregnant women, the health of the woman or her unborn child).

Some examples of problems that are most likely an emergency are:

  • Trouble breathing
  • Chest pains
  • Loss of consciousness
  • Very bad bleeding
  • Very bad burns
  • Severe pain You should call your Primary Care Provider within 24 hours after you visit the emergency room.

If you cannot call, have someone else call for you. Your Primary Care Provider will provide or arrange any follow-up care you may need.

If you need urgent or emergency care when you are out of town, go to the nearest urgent care center, hospital emergency room or call 911. If you need routine care like a checkup or prescription refill when you are out of town, call your Primary Care Provider or our Member Services Department at 1-410-779-9369, or 1-800-730-8530. TTY users should call 711. UM Health Partners’ Member Services Department is available from 8:00 a.m. to 5:00 p.m. Monday through Friday.