Learn how to select and change your Primary Care Physician.
What is a Primary Care Physician?
A Primary Care Physician (PCP) is the physician you choose to be your primary source for medical care. Your PCP coordinates all your medical care and knows your specific health history. You can designate a physician who specializes in family practice, general practice, internal medicine or pediatrics and is in your network as your PCP. Each dependent on your health insurance plan will also need a designed PCP. Everyone on your health insurance plan may have a different PCP.
Do I need to select a PCP?
Blue KC members who are enroll in the Blue-Advantage® and BlueCare® HMO health insurance plans need to select a PCP. If you enroll in a PPO plan, you do not need to designate a PCP.
How do I select or change my PCP?
You will first select your PCP during open enrollment. To change a PCP, log in and click the “Change PCP” button in the “My Account at a Glance” section on the left side of the page. Once your PCP change has been processed, Blue Cross and Blue Shield of Kansas City (Blue KC) will send you a new member ID card with your newly selected PCP on it. To ensure your PCP change is effective the first day of the following month, your change request must be submitted by the 15th day of the current month. You may also call the Customer Service number listed on your member ID card to change your PCP over the phone. Please note that if you have health insurance through your employer, you may be required to contact your group benefits administrator to change your PCP.
What if my PCP no longer participates in the network?
If your PCP no longer participates in the network, you will be assigned a new PCP. If you are not satisfied with the PCP assigned to you, you may change your PCP.
Why didn't I receive the PCP I signed up for during open enrollment?
The PCP you may have selecting during open enrollment may not be accepting new patients. Or, you may have chosen a physician who is classified as a specialist. Specialists cannot be designated as a PCP. Physicians who specialize in family practice, general practice, internal medicine or pediatrics can be designated as your PCP. If you are not satisfied with the PCP assigned to you, you may change your PCP.