PCP: Primay Care Physician. Applies to internists, family physicians and general practitioners.

Provider: Refers to anyone providing medical services. It usually means a doctor.

Covered Services: Medical and supply services will be provided and paid for by the county health plan.

Copay: The part of a medical expense that you must pay for.

Emergency: A medical condition with acute symptoms. Any condition that could cause serious injury if you do not get immediate medical attention.

Eligibility: When you qualify for coverage under the county health plan.

Enrollment: To be covered under the Bay Health Plan. You will receive an enrollment card after you are enrolled in the plan.This means your medical and pharmacy bills will be paid by Bay Health Plan.

Enrollee: A person who is a member of Bay Health Plan.

Enrollment Card (ID Card): A card that you receive when you are enrolled in the county health plan.The card lets providers know you belong in the county health plan.

Medical Emergency: See Emergency.

Prior Authorization: A medical service that requires approval by Bay Health Plan before the enrollee may receive it.

Referral: Permission from your Primary Care Physician to see another provider in the health plan network.

Specialist: A physician (not your Primary Care Physician) who provides certain services that your PCP does not provide. Some examples of a specialist are dermatologist (skin doctor), cardiologist (heart doctor) or ophthalmologist (eye doctor).

Covered services must be provided by your primary care physician or a provider contracted to provide medical services for Bay Health Plan.This doctor may refer you to a non-contracted provider when necessary. If you seek services from a non-contracted provider without a referral, you will be responsible for payment.

The covered services depend on the plan you have enrolled in. Use the links at the top of this page to learn the details of the various plans. Covered services listed for each plan are a summary. This does not mean that all related services will be paid by Bay Health Plan. Covered services under any plan are subject to change.