A Health Care Plan that Cares for People First.
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Point of Service Certificate of Coverage (English) adobe pdf
Punto de Servicio Certificado de Cobertura (En Español) adobe pdf
Members receive a Certificate of Coverage document when enrolled with FirstCarolinaCare. View and download the Certificate of Coverage for Point of Service Health Plans by clicking on the appropriate link above.

Tips

Always use a participating provider to receive In-Network benefits.

Precertification is required on certain covered services and is explained in the Certificate of Coverage under the heading “Utilization Management”. If Precertification is not completed prior to service, your benefits will be either reduced by 20 percent or will become Out Of Network benefits depending upon your benefit plan. You should call Member Services at 1-800-811-3298 if you have any questions on Precertification requirements. View the Pre-certification List for an outline of services that require pre-certification.

Please call 1-800-574-8556 for any question regarding Case Management.

Members can lower your Pharmacy Co-payment by choosing a Generic Drug instead of a Brand Name Drug. For information regarding pharmacy benefits, to find a participating pharmacy, or for questions regarding pharmacy claims, call MedImpact Customer Service Center at 1-800-788-2949 .

A Nurse Help Line is available 24 hours a day, 365 days a year to provide personal health care advice and support as well as general health information.

Members also received a Schedule of Medical Benefits document when enrolled with FirstCarolinaCare. Please review this document carefully for more information on copays, coinsurance, and deductibles for covered services at both the In-Network and Out-of-Network benefit levels.

If you have any questions about your benefits, call Member Services