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Primary Care Providers/Proveedores de Atención - Amerigroup

Primary Care Providers/Proveedores de Atención - Amerigroup

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You are responsible for paying any cost-sharing you owe to the provi<strong>de</strong>r. However, you should<br />

not be billed for the full cost of the service. Ask the non-plan provi<strong>de</strong>r to bill us first. If you have<br />

already paid for the covered services, we will reimburse you for our share of the cost. If you get<br />

a bill for the services, you can send the bill to us for payment (see your Evi<strong>de</strong>nce of Coverage<br />

for instructions on submitting a bill). We will pay your non-plan provi<strong>de</strong>r for our share of the<br />

bill, and we will let you know what, if anything, you must pay.<br />

����������������������������������������������������������������<br />

If you need care when you are outsi<strong>de</strong> the service area, your health care coverage is limited.<br />

The only services we cover when you are outsi<strong>de</strong> our service area are care for a medical<br />

emergency (including post-stabilization care), urgently nee<strong>de</strong>d care, renal (kidney) dialysis, and<br />

any other care that <strong>Amerigroup</strong> or a plan provi<strong>de</strong>r has approved in advance. If you have<br />

questions about whether a service is covered when you travel, please call Member Services.<br />

Emergency and post-stabilization care can always be obtained in or out of the service area from<br />

the nearest available provi<strong>de</strong>r. When you are in the service area, you must use plan provi<strong>de</strong>rs<br />

for urgent care. When you are outsi<strong>de</strong> of the service area, urgent care may be obtained from<br />

the nearest available provi<strong>de</strong>r. In addition, when outsi<strong>de</strong> of the service area, you can obtain<br />

dialysis treatment from any qualified dialysis provi<strong>de</strong>r.<br />

You must use plan provi<strong>de</strong>rs except in emergency or urgent care situations or for out-of-area<br />

renal dialysis. If you obtain routine care from out-of-network provi<strong>de</strong>rs, neither Medicare nor<br />

Amerivantage will be responsible for the costs.<br />

What is the service area for Amerivantage?<br />

The counties in our service area are listed below.<br />

This directory is for Fort Worth, Texas � Denton and Tarrant counties.<br />

How do you find Amerivantage provi<strong>de</strong>rs in your area?<br />

The following pages contain listings of <strong>Amerigroup</strong> Medicare Advantage plan provi<strong>de</strong>rs. There<br />

are separate listings of PCPs, specialty physicians, hospitals and other provi<strong>de</strong>rs. The list of<br />

network pharmacies is in the second part of this booklet. The lists are organized by county and<br />

specialty. Within each specialty, the provi<strong>de</strong>rs are listed alphabetically by name. To find a<br />

provi<strong>de</strong>r, locate the county you are interested in, then view the provi<strong>de</strong>rs in alphabetical or<strong>de</strong>r.<br />

There is also a listing of primary care offices that have personnel who speak foreign languages.<br />

This list is organized by language.<br />

If you have questions about Amerivantage or require assistance in selecting a PCP, please call<br />

our Member Service Department at 1-866-805-4589, 8:00 a.m. to 8:00 p.m. local time, 7 days a<br />

week. TTY users should call 1-800-855-2880. Or, visit www.myamerigroup.com/medicare.

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