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.

You can lower your Pharmacy Co-payment by choosing a Generic Drug instead of a Brand Name Drug. Make sure you discuss your options with your provider. 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 to you 24 hours a day, 365 days a year to provide personal health care advice and support as well as general health information.

You also received a Schedule of Medical Benefits document when you 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.