Members have the flexibility to select any one of the three options each time they seek care.
The PCP serves as the manager of medical care. Care that is received based on a referral from the PCP is also included under this option. Accessing care through Option 1 saves members time and money. The PCP is responsible for filing claims, placing referrals for specialty care, and for obtaining precertification of care . The out-of pocket expenses to the member are lowest under this option.