Below are common questions asked by members about covered medical services. If you don't find the answer to your question, you should use the Contact Us page on this Web site to reach Delaware Physicians Care or call Member Services at 1-866-543-2167.
Q.
How do I contact the Delaware Physicians Care Member Services department? What other important phone numbers might I need?
What if I lose my Delaware Physicians Care ID card?
What if I lose my Delaware Division of Social Services ID card?
Which dentist can I see?
How can I find out the name of my Primary Care Physician (PCP)?
How does someone become assigned to Delaware Physicians Care?
Why are Delaware Physicians Care members sometimes assigned to a PCP?
How can I change my PCP?
How do I see a specialist?
What if I have an emergency while in another state?
Why do Delaware Physicians Care members lose their Medicaid benefits?
What if I receive a bill -- what can be done?
Is transportation available to a doctor’s appointment?
What should I do if I’m pregnant?
How do I know if my new baby is covered?
Who do I call if I have a chronic disease or illness? A chronic disease might be:
How can I talk to a case manager at Delaware Physicians Care?
How do I contact the Delaware Physicians Care Member Services Department? What other important phone numbers might I need?
A.
You can reach Member Services by calling 1-866-543-2167. If you need behavioral health services, call 1-866-543-2383. To reach the Delaware Division of Social Services, call 1-800-372-2022. To reach EDS, call 1-800-996-9969. back to top
Call Member Services at 1-866-543-2167 and request a new ID card. back to top
Call Delaware Division of Social Services at 1-800-372-2022 and request a new ID card. back to top
Dental services for members under age 21 are covered through the Delaware Medical Assistance Program. Delaware Physicians Care and the Delaware Medical Assistance Program do do not cover dental services for members over age 21. To find out more about dental services for members under age 21, please call the Delaware Division of Social Services at 1-800-372-2022. back to top
Call Member Services at 1-866-543-2167 or look on your member ID card. back to top
Members may choose either Delaware Physicians Care or Diamond State Partners when enrolling in the Medicaid program. Members who do not choose a health plan will be assigned to a health plan. back to top
The PCP is responsible for coordinating all of a member’s health care needs. If a member does not choose a PCP, Delaware Physicians Care will automatically assign a PCP. back to top
Members may change their PCP up to three times every 12 months. Call Member Services at 1-866-543-2167 to change your PCP. back to top
How does a Delaware Physicians Care member see a specialist?
The PCP will make a referral to a specialist when necessary. back to top
Go to the nearest emergency room and present your Delaware Physicians Care member ID card. Do not pay for the services. The emergency department should bill Delaware Physicians Care using the information on the back of your ID card. back to top
Members may lose eligibility if they do not provide the information to Delaware Division of Social Services to determine ongoing eligibility or if they no longer meet the eligibility requirements. back to top
What if a member is billed -- what can be done?
Give the provider the claims information off the back of your Delaware Physicians Care member ID card and ask him or her to bill Delaware Physicians Care. back to top
Yes. Call LogistiCare at 1-866-412-3778 for help getting to your doctor. Delaware Physicians Care will cover your emergency transportation services. back to top
Delaware Physicians Care members should notify the plan of their pregnancy right away so the health plan can enroll you into a maternity care program. Simply call Member Services at 1-866-543-2167. back to top
Newborns are eligible for Delaware Physicians Care covered health services from their date of birth. However, each newborn must have his or her own ID number before receiving services. To have your baby added for coverage, call your caseworker at the Delaware Division of Social Services (DSS) as soon after birth as possible. Once you receive your newborn's Medicaid number, you will need to call Delaware Physicians Care Member Services at 1-866-543-2167 to choose a PCP. Your baby will then be issued a Delaware Physicians Care member ID card. back to top
Programs exist to help members with a chronic disease or illness. Call Member Services at 1-866-543-2167 for more information. back to top
Call Member Services at 1-866-543-2167 to talk to a case manager. back to top