Questions & Answers

qna

Q. How do I get medical services? 
A. You should get all health care from Passport Healthcare providers. Your Provider Directory lists all the providers that are part of the plan. If you need a printed copy, call Member Services. It also lists other places you can go.

You can get the care you need from your Primary Care Provider (PCP). Your PCP can help you with the following:

  • Checkups
  • Tests and results
  • Shots
  • Illnesses
  • Specialist visits
  • Hospital visits

Your PCP name and number is located on your Member ID Card. If you need help, call Member Services.

You may also see these providers for physical exams and preventive care:

  • Federal Qualified Health Centers
  • Rural Health Clinics
  • County Health Departments

Q. How do I change my provider?
A. If for any reason you want to change your PCP, you must first call 
Member Services and ask for a new PCP. You may also request a PCP change at MyPassportHealthPlan.com.

  • Each member of your family can have a different PCP or you can pick the same PCP for the entire family. If you have questions, please call Member Services.
  • If you need to change your PCP, call Member Services. You will be sent a new Member ID Card. The Member ID Card will have the new PCP’s name, phone number and effective date of the change.
  • If your PCP has changed, call your new doctor to fill out a Medical Records Release Form. This will help your new doctor get your medical records from your previous doctor.

Q. How do I get translation services?
A. If you prefer to speak in your own language, Member Services can help. There is no cost to you. Call 
Member Services. If you are hard of hearing, call our TTY line. An interpreter will be available to speak with you. If you have an appointment, your doctor can help you find an interpreter at no cost to you. They can also help you speak to the doctor. An interpreter can help you:

  • Make an appointment.
  • Talk with your doctor or nurse.
  • Get emergency care.
  • File a complaint, grievance or appeal.
  • Get help from a pharmacist about taking medicine.

Q. What is a prior authorization?
A. Some treatments and services must be approved by your doctor or Passport. When an approval is needed, it is called a “prior authorization”. Your PCP will take care of any authorizations you need.

Q. Who can I call with questions, concerns or complaints?
A. Our 
Member Services team can help you. Our staff is bilingual and can answer any questions that you may have about your health plan benefits.

Q. How does Passport look at new services?
A. Passport uses a medical review process to rate:

  • A new drug
  • Medical device
  • Medical rule or procedure
  • Surgical rule or procedure
  • Behavioral health rule or procedure
  • Therapy

We want to make sure that it is safe for sure. We also want to know if it is good for a medical symptom or condition. It is compared to cures. The goals of this process are:

  • To review and update coverage choices as new scientific proofs are found.
  • To review cases in order to decide if it is a certain service we should cover or not.

Passport may deny a drug, device, protocol, procedure or other therapy that is new. We might say it is not medically necessary. If this happens, you can ask us why. You or your doctor can ask for this information. You can have copies of all the rules and procedures we used to make the decision. For information on this process, call Member Services at (800) 578-0603.

Q. How do I get behavioral health services?
A. We can help you get behavioral health services. We can find you help for drug and alcohol abuse. Call (800) 578-0603, TTY/TDD: 711.

Q. When do I get my new Member Handbook and Member ID Card?
A. You should receive your 
Member Handbook and Passport Member ID Card within 14 days after your enrollment is effective with Passport.

Q. What if I need a dentist?
A. If you need dental services, you must get care from any dentist who accepts Avesis. To find the nearest dentist in your area, call (800) 578-0603, TTY/TDD: 711.

Q. What if I need vision care?
A. Your vision care is provided to you by March Vision. To find the vision care center nearest you, call (800) 578-0603, TTY/TDD: 711.

Q. What if I need transportation?

A. Emergency Transportation:

If you need emergency transportation (an ambulance), call 911.

Non- Emergency Transportation:

Non-emergency medical transportation is available if you can’t get a free ride to a covered service.

How to Get Non-Emergency Transportation:

Kentucky Medicaid will pay to take some members to get medical services covered by Kentucky Medicaid. If you need a ride, you must talk to the transportation broker in your county to schedule a trip.

Each county in Kentucky has a transportation broker. You can only use the transportation broker for a ride if you can’t use your own car or don’t have one. If you can’t use your car, you have to get a note for the transportation broker that explains why you can’t use your car. If you need a ride from a transportation broker and you or someone in your household has a car, you can:

  • Get a doctor’s note that says you can’t drive
  • Get a note from your mechanic if your car doesn’t run
  • Get a note from the boss or school official if your car is needed for someone else’s work or school
  • Get a copy of the registration if your car is junked
  • Kentucky Medicaid doesn’t cover rides to pick up prescriptions

For a list of transportation brokers and their contact information, please visit the website www.chfs ky.gov/dms or call Kentucky Medicaid at 18006352570. For more information about transportation services, call the Kentucky Transportation Cabinet at 18889417433.

The hours of operation are Monday through Friday, 8 AM to 4:30 PM ET and Saturday 8 AM to 1 PM ET. If you need a ride, you have to call 72 hours before the time that you need the ride. If you have to cancel an appointment, call your broker as soon as possible to cancel the ride.

  • You should always try to go to a medical facility that is close to you. If you need medical care from someone outside your service area, you have to get a note from your PCP. The note has to say why it is important for you to travel outside your area. (Your area is your county and the counties next to it).

If you have an emergency and need an ambulance, you must call 911.

Q. How can I get specialty care?
A. Your PCP will take care of most of your needs. There will be times when you will need to see other type of doctors. These doctors are called specialists. Examples of specialists are:

  • Cardiologist
  • ENTs (Ear, Nose & Throat)
  • Neurologist
  • Allergists

There are some providers that do need referrals. For example:

  • Gynecologist
  • Dermatologist
  • Psychologist

It is a good idea to check with Member Services if the doctor is part of Passport. If you need a provider that is not part of Passport, call your PCP to get prior approval from Passport.

Q. What if my doctor sends me for lab tests?
A. Your doctor will be sending you to a Passport network provider. If you need to visit an out-of-network provider or for more information, contact 
Member Services

Q. How do I make an appointment?
A. You should see your PCP within 90 days of your enrollment or sooner. You should be able to get an appointment with your PCP or a specialist as follows:

  • Urgent Care – within (1) day
  • Routine Sick Care – within (3) days
  • Well Care – within (1) month

Please contact us if you cannot get an appointment when you need one. You may call Member Services for help.

Q. How do I join Passport Healthcare?
A. If you qualify for Medicaid and want to become a member call The Commonwealth of Kentucky Department for Medicaid Services (DMS), Department for Community Based Services (DCBS) at (855)-306-8959

You can also click to apply

Once you submit your application DCBS will review and determine if you are eligible for Medicaid benefits.