Members
- Questions about Managed Care enrollment?
Contact the South Carolina Healthy Connections Choices customer service center:
- Phone: 1-877-552-4642
- TTY (for hearing impaired): 1-877-552-4670
- Fax: 1-877-552-4672
- SC Choices
An enrollment counselor is available Monday - Friday, 8 a.m. - 6 p.m., excluding South Carolina state holidays.
- ID Cards FAQs
Is the PCP's name on their card? If so, is a new card issued if they change their PCP?
If the beneficiary is enrolled with an MCO, the PCP's name appears on the front of the MCO card. As such, when a beneficiary changes his/her PCP, the MCO issues him/her a new card. Beneficiaries enrolled with an MHN do not receive a separate card, so their PCP will not be displayed on their South Carolina Healthy Connections ID card.
Which card should beneficiaries use? The plan card or the Healthy Connections Medicaid card?
Beneficiaries should always carry whatever cards have been provided. Beneficiaries enrolled with an MCO are issued a card from the MCO, as well as a Healthy Connections Medicaid card. They should always have both cards with them. In most cases, they will use their MCO card for services. Beneficiaries enrolled with the MHN, SC Solutions, will only have the SC Healthy Connections Medicaid card.
- Primary Care Physicians (PCP) FAQs
Can enrollees change primary care providers?
Yes. Members should contact their plan's Member Services area if they want to change their PCP.
What should be done if a patient is incorrectly enrolled with a PCP?
Beneficiaries should contact their plan's Member Service area.
If the beneficiary is enrolled in a plan, and the primary care provider that is chosen isn't the one they normally see, what do they do?
They need to call their plan and ask to change their PCP.
What is the process for choosing a PCP?
Beneficiaries will be asked to select a PCP upon calling Maximus to enroll in a health plan. Beneficiaries who do not choose a PCP will be assigned to a PCP. Beneficiaries can change their PCP by calling their plan and requesting a change.
Does a beneficiary have a PCP in a MHN?
Yes. For assistance choosing a PCP, the beneficiary should contact the MHN.
- Pharmacy FAQs
With psychiatric drugs, do the plans have to give prior authorization?
Each plan has its own drug formulary, a list of covered prescription drugs. Some of these drugs will require prior authorization (PA). For questions concerning prescription drugs, the beneficiary should call his/her plan's Pharmacy Services area.
What are the proper procedures to follow when the beneficiary has pharmacy problems?
Specifically, the pharmacy does not accept the plan the client has been placed into. The beneficiary should utilize an in-network pharmacy. For assistance locating an innetwork pharmacy, the beneficiary should be encouraged to call their plan.
Where can we get a list of pharmacies participating in each plan?
This information can be found on each plan's website.
Can the pharmacy override and let the person get the prescription that they need?
Yes. All plans have an override policy that has been communicated to pharmacies via a Medicaid bulletin.
- Quality Initiatives