For the most part, you must use doctors, hospitals, and other health care providers that are in our provider network. Our provider network is the group of doctors, therapists, hospitals, facilities, and other health care providers that we work with. You can choose from any provider in our provider network. This is called your freedom of choice. If you use a health care provider that is not in our network, you may have to pay for that appointment or service.
You will find a list of providers that are in our network in our provider directory. If you want a copy of the provider directory, call 1-833-FCC-PLAN to get a copy or visit our website at www.fcchealthplan.com.
If you are in the LTC program, your case manager is the person who will help you choose a service provider for each of your services. Once you choose a service provider, they will contact them to begin your services. This is how services are approved in the LTC program. Your case manager will work with you, your family, your caregivers, your doctors and other providers to make sure that your LTC services work with your medical care and other parts of your life.
There are times when you may need to speak to a therapist or counselor if you are having any of the following feelings or problems:
We cover many different types of behavioral health services that can help with issues you may be facing. You can call a behavioral health provider for an appointment. You can get help finding a behavioral health provider by:
Someone is there to help you 24 hours a day, 7 days a week.
You do not need a referral from your PCP for behavioral health services.
If you are thinking about hurting yourself or someone else, call 911. You can also go to the nearest emergency room or crisis stabilization center, even if it is out of our service area. Once you are in a safe place, call your PCP if you can. Follow up with your provider within 24-48 hours. If you get emergency care outside of the service area, we will make plans to transfer you to a hospital or provider that is in our plan’s network once you are stable.
There are some services that you can get from providers who are not in our provider network. These services are:
If we cannot find a provider in our provider network for these services, we will help you find another provider that is not in our network. Remember to check with us first before you use a provider that is not in our provider network. If you have questions, call Member Services at 1-833-FCC-PLAN.
Your dental plan will cover most of your dental services, but some dental services may be covered by your medical plan. The table below will help you to decide which plan pays for a service.
Type of Dental Service(s)
Dental Plan Covers:
Medical Plan Covers:
Covered when you see your dentist or dental hygienist
Covered when you see your doctor or nurse
Scheduled dental services in a hospital or surgery center
Covered for dental services by your dentist
Covered for doctors, nurses, hospitals, and surgery centers
Hospital visit for a dental problem
Prescription drugs for a dental visit or problem
Transportation to your dental service or appointment
What Do I Have To Pay For?
You may have to pay for appointments or services that are not covered. A covered service is a service that we have to provide in the Medicaid program. All of the services listed in this handbook are covered services. Remember, just because a service is covered, does not mean that you will need it. You may have to pay for services if we did not approve it first.
If you get a bill from a provider, call Member Services. Do not pay the bill until you have spoken to us. We will help you.
You can choose from any provider in our provider network. This is called your freedom of choice. If you use a health care provider that is not in our network, you may have to pay for that appointment or service.
You will find a list of providers that are in our network in our provider directory.