Common Questions

What is a health plan?
A health plan is a group of healthcare providers including primary care doctors, specialists, home healthcare providers, pharmacies, therapists, and so on. When you choose your doctor, you choose a health plan. This means you can only use the providers in that health plan.
If you do not know which health plan you are enrolled in, please call the EDS Member Hotline at (800) 457-4584.
How do I get more information on CHIP or Medicaid?
Please look through our helpful Web sites for a range of Web sites that can answer your questions.
Can I choose a doctor for my baby before the birth?
Yes, you should choose a doctor for your baby before the baby is born. Please fill out your choice of doctor on the Pre-Birth Selection Form. The Pre-Birth Selection Form can be found in the members and providers resources sections.
How can I change my PMP?
To change your PMP, please call Member Services at (877) 647-4848.
How do I file a complaint?
If you have a complaint about your PMP, please call Member Services at (877) 647-4848.
How can I request a new card?
If you need to request a new card, please call or visit your caseworker.
What do I do if I need to miss or have missed a doctor appointment?
If you need to miss a scheduled appointment with a provider, you need to call the doctor’s office as soon as possible. Most offices consider 24-48 hours notice acceptable.
If you remember that you have missed an appointment, you should call your doctor’s office to apologize, explain why the appointment was missed, and reschedule.
Please remember to cancel and reschedule any Transportation (ride) services you have scheduled for your doctor visit.
What if I need medical attention and my doctor’s office is closed?
Make sure you get the number where you can reach your doctor after hours. A qualified medical professional is available to you 24 hours a day to give you medical advice and tell you what you should do. Call NurseWise, our nurse-on-call at (877) 647-4848, then press option 7.
Never go to the emergency room unless you have a true emergency. True emergencies are when waiting for treatment would result in lasting injury or death.
Some examples include:
  • Chest pain
  • Broken bones
  • Bleeding that cannot be stopped
  • Drug overdose

For more information on emergencies, read this brochure: Emergency Room: When to Use It, When Not to Use It (PDF).

Do I have to get my doctor to approve all healthcare services?
There are some types of services that you can get on your own without seeing your personal doctor first.
These include:

  • Basic eye care (eye surgeries require a doctor’s approval)
  • Dental services
  • Foot care
  • Chiropractic services
  • Family planning

Some services need a referral from your doctor, such as:

  • Going to the hospital
  • Needing to see a specialist

Your OB/GYN can refer you to see a specialist.

Where do I call if I have questions about a claim?
If you need claim information, you should call Member Services at (877) 647-4848. All dental claims are handled by EDS (Electronic Data Systems). If you have a question about a dental claim, please call EDS at (800) 457-4584.
Who do I call if I need translation services when I go to the doctor?
Language assistance is available 24 hours a day, 7 days a week, including holidays and weekends.
If your doctor does not speak your language, he or she must provide you with access to someone who does. If your doctor does not have language services for members who speak a language other than English, MHS will help you. We provide language services in more than 150 languages. Let your doctor know if you need a face-to-face interpreter. If your doctor does not have one, please contact MHS at least 7 days before your visit, so we can make these plans for you.
Can’t find the answer you need?
For more information on MHS’ covered services, view the Member Handbook.
If you would like to submit a question to the Common Questions page, please go to contact us, and be sure to put “Common Questions” in your subject.
 
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