A Primary Care Provider (PCP) can be a doctor, physician's assistant, or nurse practitioner, and may include other providers within a health care practice, clinic, or center. A PCP is the main health care provider responsible for managing your care.
How can my PCP help me?
Your PCP will:
- Manage all your healthcare needs as they know your medical history and health conditions best.
- Provide preventive care, such as tests and immunizations, to help keep you well.
- Refer you, or give approval, to see another doctor or specialist for services your PCP doesn’t provide.
Many PCPS are available 7 days a week, 24 hours a day to ask urgent questions about your health needs.
- If the PCP can’t see you right away, you can go to an urgent care center.
- If you have an emergency, you can go to the emergency department.
How do I choose a PCP?
To see who is accepting new MaineCare members, call MaineCare Member Services at 1-800-977-6740. TTY users dial 711. Office hours are Monday through Friday, 7:00 a.m. to 6:00 p.m. If enrolled with Primary Care Case Management (see PCCM information below), you must choose a PCP. It is important that you choose the PCP who is best for you. If you do not choose a PCP, MaineCare will choose one for you. A PCP will be chosen within 30 minutes from your home.
What do I need for an appointment with my PCP?
Make an appointment with your PCP right away.
Once you have a PCP, you should call them to make an appointment. Do not wait until you are sick. To get the best care, you should know your PCP and your PCP should know you. You must have an appointment with your PCP before he or she can refer you to a specialist.
Call ahead for an appointment.
If you need a ride to a MaineCare-covered service, you can use Non-Emergency Transportation (NET) to get there. Once you have your appointment scheduled, call the transportation agency that is closest to you as soon as possible. See our Transportation webpage for the brokers’ contact information.
Keep your appointments and be on time.
Call your provider if you are going to be late or if you cannot keep an appointment. MaineCare does not pay providers for missed appointments. Your provider may not see you again if you miss an appointment.
Take your MaineCare card to all your appointments.
If you do not have your MaineCare card with you, your provider may not see you.
What if I am sick or have an injury?
Call your primary care provider if it isn’t an emergency.
What is Primary Care Case Management (PCCM)?
Through PCCM, MaineCare helps members and providers work together to manage a member’s care. Many members are part of this program. For more detail, see the PCCM Questions and Answers (PDF).
What is an Accountable Community (AC)?
An AC is a group of doctors and other healthcare providers that work together to give better care to their patients and lower the costs of healthcare services. For details about this program, see the example of an AC Member Letter (PDF).
What if I have chronic health conditions?
If you have chronic health conditions, you may be eligible to participate in a Health Home, Behavioral Health Home, or Opioid Health Home.
Health Homes - Health Homes are a partnership between an primary care practice and a Community Care Team (CCT) to manage members with certain chronic conditions.
Behavioral Health Homes - Behavioral Health Homes (BHH) are a partnership between a licensed community mental health provider and one or more Health Home practice to manage the physical and behavioral health needs of eligible adults and children.
Opioid Health Homes - Opioid Health Homes (OHH) deliver integrated office-based Medication Assisted Treatment (MAT), opioid dependency counseling, and comprehensive care management for eligible MaineCare members and uninsured individuals with opioid use disorder.
MaineCare Member Services:
- Call 1-800-977-6740. TTY users dial 711.
- You can also email.
Office hours are Monday through Friday, 7:00 a.m. to 6:00 p.m.