PHP FamilyCare is a Medicaid program backed by Physicians Health Plan.  The program offers benefits that will help you with your health care needs. For more information about Medicaid eligibility, click here.

Show your PHP FamilyCare card, your mihealth card and all other medical cards each time you receive services.  Click here.

As a PHP FamilyCare member, you will receive a packet of information, which includes:

• Certificate of Coverage:  Explains your health coverage.
• Member Handbook:  Explains how to use your health care benefits.
• PHP FamilyCare Wallet:  Holds your PHP FamilyCare ID, mihealth card and any other medical cards.
• Advance Directives:  Explains your right to accept or refuse medical or surgical treatment if you are unable to express your wishes.
• Privacy Notice:  Describes how your health and personal information may be used.

To view your PHP FamilyCare covered benefits, please click below: 

PHP FamilyCare Covered Benefits 

You must choose a PCP to provide for your health care needs. Please make a "get to know you" visit. If you move or your PCP moves and you want to change your PCP, call Customer Service toll free at 1.800.661.8299.

• Doctors must be available seven days a week, 24 hours a day.
• First time visits are to be offered within eight weeks after you call.
• Regular visits are to be offered within four weeks after you call.
• Waiting times shall not regularly be more than 30 minutes from your scheduled appointment time until you are seen by your doctor.
• Your PCP will also give you a referral for other services you receive.  Those services could be outpatient hospital care, or medical supplies like wheelchair and crutches.  If you receive any of these services without a referral from your PCP, you will have to pay for them.
• If you have urgent care needs, you are to be offered to be seen within 24 hours of your call.  If you are away from home and become ill, please call your PCP.  You will advised to go to an urgent care center or a doctor's office.  Your PCP will need to send PHP FamilyCare a referral for these services.  Routine care is not covered when you are out of the PHP FamilyCare Service Area.  Your PCP should provide all of your routine medical care.
• If you have symptoms that are not urgent, you are to be offered an appointment within five days.
• If you have an emergency, you are to be offered to be seen right away.
• If you are away from home and have an emergency, go to the nearest hospital.  The hospital can call PHP FamilyCare to verify that you are covered. 
  
  If you are having problems getting care when you need it, call our FamilyCare Customer Service Department at 1-800-661-8299 and ask for a Medicaid Health Advocate. We will be glad to help.  

If you or your children are under age 21, you need to have a free well-child exam. During the exam, your PCP may find a health problem you did not know was there. The earlier you can catch problems, the easier they are to treat. Click here for more information. (you will need Adobe Acrobat Reader to view this information.)

It is a good idea for adults to have a doctor's office visit once a year with their PCP or OB/GYN. It is best for male members to visit their PCP once a year.  Female members can call for a routine OB/GYN visit.  If you do not have an OB/GYN doctor, see your Provider Directory for a list of OB/GYN providers.

It is important to see your doctor even when you are not sick.  The table below shows who should receive preventative screenings, how often, and at what age:

• Women who are 40 years and older should have a yearly mammogram
• Women who are 21 years and older should have a PAP test yearly
• Men and women who are 50 years and older should have colorectal cancer screening
  • Fecal Occult Blood Test (FOBT)* every year, or
  • Flexible Sigmoidoscopy every 5 years, or
  • Colonoscopy every 10 years
     

If you need help, call Customer Service toll free 1.800.661.8299.

• Spring 2011
• Fall 2010
• Spring 2010
• Fall 2009
• Fall 2008
• Spring 2008

(you will need Adobe Acrobat Reader to view)

PHP FamilyCare members are eligible for special programs that may assist them in health care services.

For more information about these programs, click here.

Customer service is available to answer your benefit questions, change your PCP, order additional cards, or for other information.  To learn more about PHP's Customer Service department, click here.

Customer service is available to answer your benefit questions, change your PCP, order additional cards, or for other information.  To learn more about PHP's Customer Service department, click here.

TTY/TDD Services

This service can be used by a person who is deaf, hard-of-hearing or has problems speaking.  You must have a device with a keyboard called a Teletypewriter (TTY) or a Telecommunications Device for the Deaf (TDD).  If you have one of these special devices, call 1-800-649-3777 to reach the Relay Center.  The Relay Center will help you call the PHP FamilyCare Customer Service Department.

AT&T Language Line Service

If you have trouble speaking English, you can still call the PHP FamilyCare Customer Service Department.  We use AT&T Language Line Services.  Tell us what language you speak best and we will have an interpreter translate your questions for us and explain the answers to you.

Interpretation Services

If you speak another language or have trouble understanding your doctor, call the PHP FamilyCare Customer Service Department at 1-800-661-8299 for help.

TTY/TDD Services

This service can be used by a person who is deaf, hard-of-hearing or has problems speaking.  You must have a device with a keyboard called a Teletypewriter (TTY) or a Telecommunications Device for the Deaf (TDD).  If you have one of these special devices, call 1-800-649-3777 to reach the Relay Center.  The Relay Center will help you call the PHP FamilyCare Customer Service Department.

AT&T Language Line Service

If you have trouble speaking English, you can still call the PHP FamilyCare Customer Service Department.  We use AT&T Language Line Services.  Tell us what language you speak best and we will have an interpreter translate your questions for us and explain the answers to you.

Interpretation Services

If you speak another language or have trouble understanding your doctor, call the PHP FamilyCare Customer Service Department at 1-800-661-8299 for help.

 Medical Resource Management helps you manage your healthcare benefits and authorizes care.  Click here for more information.

• List the doctors, pharmacies and hospitals that are part of each Medicaid health plan.
• Answers general questions you may have about Medicaid benefits. 
• Enrolls members in their Medicaid Health Plan.

If you move out of PHP FamilyCare’s service area (Ingham), you will no longer be eligible for health care benefits under PHP FamilyCare.

If you move, call your caseworker at the Family Independence Agency (FIA), PHP FamilyCare, and Michigan Enrolls at 1.888.ENROLLS (1.888.367.6557).  If you lose your State Medicaid eligibility permanently, you will no longer be eligible for health care benefits through PHP FamilyCare.

However, if you lose your State Medicaid eligibility for less than 3 months, you will automatically be enrolled with PHP FamilyCare. If you lose eligibility for longer than 3 months, you will be asked again to choose a managed care plan.
 
 

PHP FamilyCare will provide transportation for covered services. You can get help if the service is approved 24 hours in advance. If you need bus passes, tokens or special transportation, call at least 5 days in advance.  Call Customer Service toll free at 1.800.661.8299.
 

PHP FamilyCare hopes that you are always satisfied with the service that you have recieved from us. We know, however, that that from time to time you may have a problem or concern that you want us to address. If you have a question, concern, or complaint; call PHP FamilyCare's Customer Service Department at 517.364.8540 or 800.661.8299. Our Customer Service staff will try very hard to respond to your questions and concerns right away. If you are still not satisfied, click here for the PHP FamilyCare appeal process.
 

You should not get billed for health care that are covered by your PHP FamilyCare health benefits plan. If you get a bill, call our Customer Service Department. Customer Service will help you determine if a mistake has been made.

There are copayments for some PHP FamilyCare pharmacy and medical services. Copayments are applied to such services as chiropractic, podiatry, hearing aids, vision care, physician office visits, and for outpatient, inpatient and emergency room hospital care. Copayments do not apply for family planning, pregnancy, mental health visits, or for members 21 years of age and younger. Contact Customer Service at 1.800.661.8299 for details.

Providers can submit claims to:

PHP FamilyCare
P.O. Box 439
Linthicum, MD 21090-0439

PHP FamilyCare values your privacy. If you would like to view a copy of the PHP FamilyCare privacy notice, please click here.