Who is Your PCP

As a member of the Upper Peninsula Health Plan, you have the benefit of having a Primary Care Provider, or PCP. A PCP is a doctor whom you choose and whom you call first when you are ill. Your PCP can send you to other doctors for special care when needed. The name of your PCP is on you UPHP medical assistance card. If there is no PCP name on your card or if the name is not correct, please call UPHP at (800) 835-2556 with the correct PCP name. If you do not have your PCP’s name on your card, you may have problems getting medical care.
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Your UPHP Member ID Cards

Always bring your medical insurance cards with you every time you get medical care. If you do not bring all your cards, you may have problems getting care. You should have three cards: a Blue Card from the State of Michigan, a UPHP Medical Assistance Card with your PCP’s name on it, and a Pro Vantage medicine card. If the information on your Blue Card is not correct, call your Family Independence Agency caseworker. If the information on your UPHP Medical assistance card or your Pro Vantage medicine card is not correct, call UPHP at    (800) 835-2556.
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HELP!  I Have An Emergency

An emergency is an injury or illness for which a delay in treatment may result in death or permanent damage to your health. An emergency could be a broken bone, severe bleeding, or severe and unusual pain. Minor medical problems such as back pain, headaches, colds and slight fever are not considered emergencies. If you are not sure if you are having an emergency, call your PCP, your nearest emergency room or CareLink^SM, UPHP’s nurse line at (800) 835-2556, to talk about your problem.

Emergency rooms and ambulances should be used for emergencies only. If you need urgent care after business hours, go to your nearest urgent care or walk-in clinic. Tell your PCP about all emergencies and urgent care that you get from your providers. Your PCP will help you get follow-up care.
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Call the Nurse CareLink^SM & BirthLine^SM

CareLink^SM is a telephone number you can call to talk with a nurse. This is a free service. The nurse can:

• Answer you medical questions and concerns.
• Help you decide how to take care of your health concerns
• Provide you with health information and materials.

BirthLine^SM is also a free telephone service you can call to talk with a nurse. You should call BirthLine^SM if you are planning to become pregnant or are already pregnant. The goal of BirthLine^SM is to improve your chances of having a healthy baby. The nurse can provide you with:

• Prenatal information
• Health assessments
• Pregnancy Monitoring
• A savings bond values at $50.

You can call CareLink^SM or BirthLine^SM at (800) 835-2556 from 7 a.m. - 9 p.m. seven days a week. (An answering service is open from 9 p.m. - 7 a.m.).
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Out-Of-Plan Referrals

UPHP is designed to offer its members the most complete choice of providers possible. UPHP has over 450 in-plan providers out of almost 500 total providers in the Upper Peninsula. Your Primary Care Provider (PCP) can refer you to a UPHP in-plan provider to take care of your special needs. If you need to see a specialist who is not an in-plan provider, your PCP must get authorization from UPHP medical management staff before you get that care. If you get special care without a referral, you may have to pay for that care.

UPHP would make an exception and authorize an out-of-plan referral from your PCP if:

• The same service is not available in-plan, or
• The care is needed under emergency conditions and the in-plan provider is not available, or
• You are currently getting treatment for a condition that your PCP feels should continue. (This exception may be made during the first 60 days after enrolling with UPHP.)
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