• First Choice
• First Choice Miembro
• Provider
• Pharmacy

Frequently Asked Questions

• How can I find a doctor in your network?
• What is prior authorization? How do I get it?
• Can I change my primary care doctor?
• What are your hours of operation? What phone number should I call?
• What is a well visit?
• How do I become a member?
• How do I know if I am eligible?
• If I can't get my medicine, can I call First Choice while I am at the pharmacy?
• What should I do if I get a bill?
• Why is First Choice asking for my race, ethnicity and language?

You can search our doctors by name, county or zip code from our website.Click here to search for a doctor in your area. You can also call our Member Services Department at 1.888.276.2020, and a representative will help you find a doctor in our network.

Some prescriptions must be approved before you can get them filled. This is called a prior authorization. If a medicine needs prior authorization, your doctor must complete a form and return it to First Choice before the prescription can be filled.

If the request is approved, a notice is sent to your doctor, and you can get your medicine. If the request is denied, you will get a letter explaining why. If you don’t agree with the denial, you can appeal the decision. To file an appeal, call Member Services at 1.888.276.2020.

Yes. Call Member Services at 1.888.276.2020, and a representative will help you change your primary care doctor. For most doctors, you can call anytime during the month, and the change will go into effect the 1st day of the next month.

Member Services is available to take your call Monday through Friday from 8 a.m. to 9 p.m. and Saturday and Sunday from 8 a.m. to 6 p.m. Please call toll free at 1.888.276.2020.

A well visit is a complete medical check-up from head to toe. Based on age, there are certain times that you (or your child) should have a well visit.

Enrollment is done through Healthy Connections Choices. If you are eligible, please contact Healthy Connections Choices at: 1.877.552.4642.

You may be eligible for First Choice if you have Medicaid through:

• TANF (Temporary Assistance to Needy Families)
• SOBRA (for Pregnant women)
• Social Security without Medicare

You are not eligible for First Choice if you:

• Have Medicare
• Are 65 or older
• Have another HMO plan
• Receive hospice care
• Live in a nursing home
• Are a foster child

Yes. If you have a problem getting your medication, please call Member Services at 1.888.276.2020 while you are still at the pharmacy.

If you receive a medical bill, call Member Services at 1.888.276.2020 as soon as possible. Please have the bill in hand when you call, so that the representative can help you.

At First Choice, we’re here to serve you. We want to make sure that all of our members get the best care possible. The more we know about you, the better we can meet your needs. The next time you talk to a First Choice customer service representative or nurse; you may be asked to share your race, ethnicity (cultural background), and preferred written and spoken language. You do not have to answer these questions. But, if you do, your answers will help us make sure that you and your family get good care.

Your information will stay private. We will only share it with your doctor and other healthcare providers. For more information about how your race, ethnicity (cultural background) and language information is protected and stays private, please read the Privacy Protections for Member Race, Ethnicity & Language Data below.

Thank you for helping us make our services better! Remember, the more we know about you, the better we can serve you!

If you have questions, please contact Member Services at 1.888.276.2020.

Privacy Protections for Member Race, Ethnicity & Language Data
Race, ethnicity and language details are necessary to provide culturally and linguistically (language) appropriate services (CLAS) to our members. The data is collected, stored, protected, and used by First Choice internal policies.

First Choice collects, stores, and reports data on members’ race, ethnicity (cultural background), and language to:

• Understand the demographics (the data of a population) of the our members,
• Measure and report any existing differences in healthcare or service, and
• Address those differences through appropriate outreach and member programs.

First Choice’s internal policies let us know when we can and can’t use race, ethnicity (cultural background) and language data. The policies also describe how members will be notified of privacy protections.

A. Data Access Control
Access to individual-level race, ethnicity (cultural background) and language data:

1. Is regulated by First Choice Information Security access controls policies.
2. Will only be provided to those persons whose jobs require access to this information.
3. Will be terminated according to First Choice Information Security access controls policies.

B. Permissible Uses of Data
Race, ethnicity (cultural background) and language data will be used to:

1. Assess healthcare differences.
2. Design intervention programs.
3. Design and direct outreach materials.
4. Inform healthcare practitioners and providers about individuals’ language needs.
5. Inform healthcare practitioners and providers to help design programs to improve your health outcomes.

C. Impermissible Uses of Data
Race, ethnicity (cultural background) and language data will not be:

1. Used to perform underwriting, rate setting or benefit determinations.
2. Disclosed to unauthorized users.

D. Notification of Privacy Practices

1. Members will be told of First Choice’s policies for use and protection of race, ethnicity (cultural background) and language data at the time of direct collection.
2. First Choice may communicate its policies for use and protection of race, ethnicity (cultural background) and language data through its standard forms of communication (examples: member handbook, member newsletters, provider newsletters, website news and information, etc.).