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Your Primary Care Physician (PCP)

A primary care physician, also called a PCP, is a doctor who takes care of you and helps you stay healthy. Your PCP will provide most of your health care. Your PCP will keep a record of your health and your health care. If you need special care for a health problem, your PCP will make the arrangements and tell you where to go. You will need your PCP's okay, called a referral, in order for Medicaid or ARKids First to pay.

Do you need a PCP?
How do you get a PCP?
How do you change your PCP?
Choosing a PCP

Do you need a PCP?

You must pick a PCP unless:

you also have Medicare.
you live in a nursing home.
you live in an ICF/MR (a home for people with mental retardation).
you are covered by Medicaid only for a past time period.
you have Medicaid "Spend-Down." (This means that you make too much to qualify for regular Medicaid, but you spend the excess amount on medical bills.)

How do you get a PCP?

The ways to choose a PCP are:

Go to the doctor's office,
Call the ConnectCare help line at 1-800-275-1131 (TDD: 1-800-285-1131),
Go to the DHS office in your county, or
List your choices for a PCP on the Medicaid or ARKids First application.

You must make sure the PCP you choose is a Medicaid or ARKids First provider. If you need a list of PCPs who take Medicaid or ARKids First, call ConnectCare or visit your county DHS office. The list tells you:

The doctor's name.
The clinic's address.
Ages served.
Languages the doctor or staff speak.
Phone numbers.

How do you change your PCP?

To change your PCP, call the ConnectCare help line at 1-800-275-1131 (TDD: 1-800-285-1131), or visit the DHS office in your county.

Choosing a PCP

For each family member on Medicaid or ARKids First, pick three doctors. If a doctor you choose cannot take more patients, DHS will try to give you your next choice. Choose carefully. Here are some things to keep in mind:

How far away is the doctor? The doctor's clinic needs to be in the county where you live or in a county right beside yours. If you live in a county that borders another state (Oklahoma, Texas, Louisiana, Mississippi, Missouri, or Tennessee), you may choose a doctor in a city on the border in that state. Make sure the doctor takes Arkansas Medicaid and ARKids First .
Do you or your family members have special needs? Look for a doctor that offers the service you need.
Is there a hospital you like best? Make sure the doctor you choose sends patients to that hospital. (Remember, for emergency care, you can use any hospital. Other times, you need a doctor's referral.)
Does a family member not speak English? Choose a doctor who speaks their language.

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