Your PCP & Medical Home

Your Primary Care Provider (PCP) is your health care provider who takes care of all your main health care needs. You can choose your PCP. Your PCP will see you for well care check-ups and medical problems. Your PCP is your medical home. A medical home helps make sure that the right medical care is available when you need it.

Get to know your PCP. It helps ensure that you get medical care from someone who knows you and from someone who you feel comfortable with.  Your PCP is your Medical Home. Your Primary Care Provider (PCP) takes care of all your main health care needs. If you have a new PCP, call your PCP and make an appointment, even if you are not sick. You can get to know each other. Your PCP will learn about your health to prevent or detect future illness.

PCPs help keep you healthy by:

  • Teaching you how to stay healthy
  • Treating a health problem before it becomes serious
  • Keeping immunizations up-to-date
  • Providing care when you are sick

If you need care after the hours:

  • Call the PCP’s office to find out how to get care after hours. If it is not an emergency, leave a message. 
  • If you still cannot reach your PCP, call our 24-HOurs Nurse Line at 1-855-620-3924 (TTY: 711).

Your PCP’s phone number is on your Aetna Better Health Member ID card. You can change your PCP at any time by calling us at 1-855-300-5528 (TTY: 711 or TDD: 1-800-627-4702). There is no limit to the number of times you can change your PCP.

If you need a free Provider Directory, call Member Services at 1-855-300-5528 (TTY: 711 or TDD: 1-800-627-4702) and we will mail one to you. Or, search for a provider.

We want you to have the best health care possible. But, sometimes a visit to your health care provider may not go as well as you’d like. So before you meet with your doctor make sure to make a list of all your questions, any concerns you may have and all medications you are taking.

  • Maybe you forgot to ask an important question.
  • Maybe you didn’t know the answer to all the questions your provider asked, such as the names of the medicines you are taking.
  • Maybe you found it hard to remember everything your provider told you to do.

This happens to many people. There is something you can do. Ask Me 3® is a program run by the National Patient Safety Foundation. The program gives you three questions to ask your provider during a health care visit. They are:

  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?

These three questions help prepare you for the visit and help you understand what your provider tells you. As a result, you are able to take better care of yourself and live a healthy lifestyle. For more information, please visit NPSF.

A medical emergency is a serious medical condition resulting from an injury or illness. Emergencies arise suddenly and unexpectedly. They require immediate care and treatment to avoid placing your health in serious harm. 

For many illnesses, you don’t need to go to the emergency room. If you have a cold, a cough or a rash, you can call your doctor. It’s the same if you have small cuts or bruises. You don’t need to go to the hospital. If you feel that you can wait to seek care, you can call your primary care provider.

Go to the nearest hospital or call 911 right away when:

  • You are afraid you may be dying
  • You have very bad chest pains
  • You have problems breathing
  • You fainted
  • You may be poisoned
  • You may have taken an overdose of medicine
  • You may have a broken bone
  • You have convulsions or seizures
  • You are badly burned
  • You suddenly can’t move (paralysis)
  • You are a victim of a violent attack (rape, mugging, stab or gunshot wound)
  • You are bleeding heavily
  • You are badly hurt
  • You have thoughts of causing harm to yourself or others
  • You are about to deliver a baby

If you need help getting to an emergency room, use a phone and dial the numbers 911. Your call will be answered 6 to12 seconds after you call. In some cases, there is about 5 to 6 seconds of silence before you hear someone answer.

Do not hang up. If you do not speak English, it is important you tell the operator what language you speak. The 911 operator must ask some questions to understand your situation and where it is happening. Stay on the telephone for as long as you can so the operator can get you help.

If you do go to the hospital, make sure to schedule a follow-up care appointment with your primary care provider.