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Frequently Asked Questions

 

 

What does PAC Cover?
PAC covers prescription drugs, primary care physician office visits, mental health care, substance abuse services, and some limited additional health services.
PAC does not cover services such as in-patient hospital stays, outpatient hospital care, emergency room visits or visits to a specialist.

Is PAC the same as HealthChoice?
No, PAC is different than HealthChoice. PAC is Prepaid Ambulatory Health Plan; it is not a full Medicaid managed care program because it has limited benefits. Click here to see the benefits.

How do I enroll with a Managed Care Organization (MCO)?
Contact Health Choice at 800-977-7388

Can a PAC member enroll for pharmacy benefits only?
No.

My benefits have been terminated, how do I re-enroll?
Contact an enrollment counselor at the PAC Services Help Line at 1-866-676-5880. 

How do I get a replacement identification (ID) card?
Contact Priority Partners at 800-654-9728. If you need a new Medical Assistance card, please contact the PAC Services Help Line at 1-866-676-5880.

How do I change my Primary Care Physician (PCP)?
Contact Priority Partners at 800-654-9728.

How do I obtain a listing of PCP’s that participate with Priority Partners?
Contact Priority Partners at 800-654-9728 or go to the “Search for a Provider” section of this website.

Are Mental Health Services covered under PAC?
Yes, primary mental health services can be provided in the PCP’s office. These services are covered by the MCO. For more serious or persistent mental health problems, PAC members have coverage for outpatient mental health services through the specialty mental health system, Value Option contact number is 1-800-888-1965.

Who do I call for mental health or substance abuse participating providers?
Yes, primary mental health services can be provided in the PCP’s office. These services are covered by the MCO. For more serious or persistent mental health problems, PAC members have coverage for outpatient mental health services through the specialty mental health system, Value Options contact number is 1-800-888-1965.

Are substance abuse services covered under PAC?
PAC members receive SA outpatient services in community-based settings.  They also receive opiod maintenance treatment provided in a community-based setting. All other approval rules for HealthChoice apply for PAC.

Do I need to contact Priority Partners prior to going to the emergency room?
No. For life threatening emergencies contact or dial 911 and then call your Primary Care Provider within 24 hours to let him or her know about the emergency.

If I pay the full price for a prescription will Priority Partners reimburse me?
Yes, as long as the prescription is on the list of medication covered by Priority Partners (see full list in the Provider section of this website). You may initially want to return to the pharmacy within two weeks of obtaining the prescription for reimbursement. After two weeks send your prescription receipts to Priority Partners. Call Customer Service at 800-654-9728 for additional information.

How can I obtain a nebulizer?
Contact Priority Partners at 800-654-9728.

When do I call my case worker?
Call your caseworker if your coverage has been terminated and you don’t know why; if you recertify your case and the coverage is still not active; to make corrections to your name or date of birth; to update your address; to notify us that you have new employment and no longer need insurance coverage; or if you’ve moved out of Maryland. Call Priority Partners to change your Primary Care Physician; to add a newborn and mom on the baby’s date of birth; to verify enrollment eligibility; or to obtain a MCO ID card.

When do I call Priority Partners’ Customer Service?
Call Priority Partners to change your Primary Care Physician; to add a newborn and mom on the baby’s date of birth; to verify enrollment eligibility; or to obtain a MCO ID card.