We believe that giving your child great medical care starts with a good relationship between your Primary Care Provider (PCP), Seton Health Plan, and you.
First, make sure you choose a PCP that accepts Seton Health Plan CHIP. Click on the Online Provider Search or the Provider Directory link (PDF document) or call member services if you don't see the doctor you want.
Second, it is very important that you always go to your PCP first. If you want to see another doctor, talk to your PCP. The PCP will discuss it with you and may refer you to a specialist. Let your doctor know what you think is best for your child.
Third, you should always be able to reach your PCP 24/7 by calling his office number. If the office is closed, you may be transferred to an answering service. They will know how to reach the doctor or ask you to leave a phone number so the doctor can call you back.
You can also call the 24-Hour Nurse Help Line at 1-888-497-8989 to help you when your doctor's office is closed.
Finally, remember that you can change your PCP at any time. Call Seton Health Plan Member Services at 1-877-451-5601 to make the change.
Your PCP will not change immediately. The change could take from 15 to 45 days depending on when you ask for it. Member Services can tell you when you can go to your new PCP.
You may not get to change your PCP if:
- The new PCP is not in the Seton Health Plan network, or
- The new PCP is not accepting new patients
