CMSP Primary Care Benefit (PCB) Program

No Share of Cost – Effective May 1, 2016

 

A NEW CMSP Primary Care Benefit (PCB) is available to CMSP Members (Aid Code 50 and 89):

  • Covered Medical Services: Includes PCP and/or Specialist office visits, preventive health screenings, laboratory tests, diagnostic tests and minor office procedures and Physical Therapy with NO Share of Cost (SOC) or Copay for covered Services. For more information on covered medical services, click here.
  • Covered Prescription Drug Services: Wide range of covered medications with a $5.00 copay and up to $1500 drug cost maximum per PCB benefit period. (Administered through MedImpact)
  • Separate PCB Identification Card: Members receive a separate PCB ID card with a separate ID number (starts with “PCB”) and this ID card and PCB number MUST BE USED to access PCB services (see example ID card below)
  • Benefit Enrollment Period: Up to 6 months and printed on the PCB ID card
  • CMSP Contracted Provider ONLY: Services must be provided by CMSP contracted providers to be payable. To find a CMSP Provider near you, click here
  • PCB Benefit Limitations: Up to three (3) medical office visits per Benefit Enrollment Period. Providers must obtain a Visit Reservation Number prior to rendering services to track PCB visits and for claims payment. For more information, click here.

Primary Care Benefit ID Card

CMSP Primary Care Benefit (PCB) Program