All member receive a member handbook when they enroll with MedStar Family Choice. This handbook provides detailed benefit information, as well as information on MedStar Family Choice policies and procedures.
To view the entire handbook in English (updated April 2024), click on the MedStar Family Choice Member Handbook.
Click here for the member handbook in Spanish.
III. Rights and Responsibilities
- HealthChoice Benefits
- Self-Referral Services
- Benefits Not Offered by MCOs But Offered By the State
- Additional Services Offered by MCOs and Not by the State
- Excluded Benefits and Services Not Covered by MCOs of the State
- Change of Benefits or Service Locations
- What is a PCP, a Specialist, and Specialty Care
- Selecting or Changing Providers
- Termination of a Provider
- Making or Canceling an Appointment
- Referral to a Specialist or Specialty Care
- After Hours, Urgent Care, and Emergency Care services
- Out-of-Service Area Coverage
- Wellness Care for Children (Healthy Kids-EPSDT)
- Wellness Care for Adults
- Case Management
- Care for Women During Pregnancy or Two Months After Delivery
- Family Planning (Birth Control)
- Dental Care
- Vision Care
- Health Education/Outreach
- Behavioral Health Services
VII. Special Services
- Services for Specialty Needs Populations
- Rare and Expensive Case Management Program (REM)
VIII. Utilization Management
IX. Billing
X. Complaints, Grievances, and Appeals
XII. Reporting Fraud, Waste, and Abuse
ATTACHMENT A - MCO Contact Information
ATTACHMENT B - Notice of Privacy Practices
ATTACHMENT C - Additional Services Offered by MCO
ATTACHMENT D - Prenatal/Postpartum Programs
ATTACHMENT E - Health Education Programs
ATTACHMENT F - MCO Internal Complaints/Grievances/Appeals Process
ATTACHMENT G - Other Important Information
ATTACHMENT H - Advanced Directives
ATTACHMENT I - MedStar Family Choice Nondiscrimination Statement
Information current as of: