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Member Handbook

Below is the MedStar Family Choice handbook that all members receive when they enroll into 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 MedStar Family Choice Enrollee Handbook Revised (October 2015)

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I. Rights and Responsibilities
II. Benefits and Services
  • HealthChoice Benefits
  • Optional Services and Applicable Terms and Conditions
  • Benefits and Services Not Offered by MFC But Offered By the State
  • Benefits and Services Not Offered by MFC or the State
  • Self-referral Services
  • Notice of Changing Benefits or Service Locations
III. Information on Providers
  • What is a PCP, a Specialist, and what is Specialty Care
  • Information about Your PCP and Specialists
  • Selecting or Changing Providers
IV. Special Services
  • Interpreter for Those Who do not speak English
  • Interpreter for Those Who are Hearing Impaired
  • Transportation Services
  • Services for Special Populations
  • Rare and Expensive Case Management Program (REM)
V. Getting Into Care
  • Making or Canceling an Appointment
  • Referral to a Specialist
  • After Hours, Urgent Care, and Emergency Care services
  • Out-of-Service Area Coverage
  • Wellness Care for Children (Healthy Kids-EPSDT)
  • Care for Pregnant Women
  • Wellness Care for Adults
  • Family Planning (See Section II-F, Self Referral Services)
  • Adult Dental Care
  • Out of Network Services
  • Health Education Programs
  • Nurse Advice Line
VI. Behavioral Health Services
VII. Complaints, Grievances, and Appeals
  • Enrollee Services and Hotline Information
  • MedStar Family Choice Internal Grievances Procedures
  • The State's Complaint Process
  • The State's Appeal Process
  • Making Suggestions for Changes in Policies or Procedures
VIII. Changing MCOs
IX. Notice of Privacy Practices
X. Reporting Fraud and Abuse
XI. Advanced Directives
Information current as of: 05/23/17