For members
Member Help Team
Isn't it good to get help from people who know you? At AmeriHealth, we realize that your health care coverage is an important part of managing your health care needs. That's why we've established the Member Help Team, a dedicated team of representatives. These professionals are experienced in handling the unique needs of our Medicare customers. Their goal is to get you the answers you need to get the most out of your health coverage.
They can help answer questions about:
- How to use your coverage
- Prescription drug coverage
- Billing
- Copays
- Provider and network concerns
Give one of your team members a call and get your questions answered. From time to time, your Member Help Team will send you mailings with tips on how to use resources available through your coverage or updates regarding product or coverage enhancements.
Contact the Member Help Team today
AmeriHealth Medigap: Call toll-free 1-866-406-5967 (TTY/TDD: 711), 8 a.m. to 8 p.m., seven days a week.
Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail.
Quality Management Program
The Quality Management (QM) program is organized around a vision of supporting optimal health outcomes and satisfaction with care for our members, as well as meeting all applicable regulatory and accreditation requirements. The QM program monitors and evaluates quality of care for our members and engages with the provider community to ensure standards of care are maintained across the network.
Sharing personal health care data
Your health care data lives in many places — with your health plan, doctor, pharmacy, and more. To help make better health care decisions, you may choose to use a third-party app or website to track and view everything in one place. Current Medicare Advantage members now have access to share their AmeriHealth health care data with a third-party app or website of their choice.
To connect your personal health information with a third-party app or website, you will need to provide an authorization to AmeriHealth. To provide authorization, you will use your AmeriHealth member site username and password. If you do not have access to the AmeriHealth member site, go to amerihealth.com/login to register and create a username and password.
The federal government created the Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) Interoperability and Patient Access API Rule to aid in this effort. The goal is to simplify the patient's experience and provide better access to health care data (also known as personal health information).
Understanding data sharing
Your AmeriHealth personal health information that will be available to share includes claims, encounter, prescription drug, and clinical data. Keep in mind that your shared personal health information cannot be limited and may include sensitive information about your past treatments. If you decide to share your personal health information with a third-party app or website, it is important to carefully review the third-party company's privacy policy.
To learn more about the CMS ONC Interoperability and Patient Access API Rule, personal health information, and things to consider when choosing a third-party app or website, please review Educational Materials — details about sharing your data.
How to get started
To get started, find a third-party app or website that has AmeriHealth as an available data-sharing vendor. Make sure to review the third-party app's or website's privacy policy to understand how they will use, maintain, and/or further disclose your information.
When you have chosen a third-party app or website, complete the following steps:
- Download the third-party app, or when available, use a third-party website.
- Connect your health care data by following the directions provided on the third-party app or website.
- Provide authorizations for AmeriHealth to share your health care data using your AmeriHealth member site username and password. During the authorization process, you must read, agree, and complete the following materials:
- View your health care data within the third-party app or website.
What happens next
After you authorize sharing your personal health information, the process is complete. Data will be shared immediately with the third-party app or website. You will receive a confirmation email from AmeriHealth, and a signed version of the authorization documents will be saved on your AmeriHealth member site for your records. You will use the third-party app or website to view your shared health care data.
Data sharing will be available for up to 365 days after you provide authorization. You can revoke/stop data sharing access at any time. Simply log in at amerihealth.com/login and revoke access under "Account settings." Or, contact our Member Help Team at the number on the back of your member ID card. AmeriHealth will stop sharing your data immediately and will not send any new data to the third-party app. You will receive a confirmation email.
AmeriHealth will not get your previously shared data back from the third-party app or website. You should contact the third-party app or website to request they delete your personal health information from the app. This will depend on the third-party app's or website's privacy policy.
For more information about sharing your health care data, read our frequently asked questions.
Medical Policy
For more information regarding our medical policies, visit our Medical Policy Portal.
Drug Management Program
Our Drug Management Program (DMP) can help make sure our members safely and properly use their prescription opioid or other frequently abused medications. If you use opioid medications that you get from several doctors or pharmacies, we may talk to your doctors to make sure your use is appropriate and medically necessary.
Member health and safety is our top priority. We recognize how certain medications have higher rates of abuse and are more likely to lead to addiction. This is why we have our Drug Management Program (DMP). The DMP is another way in which we make sure our members have the resources, support, and accountability they may need.
Drugs, alcohol, and tobacco
Spouses and families play a crucial role in helping loved ones stay drug-, alcohol-, and tobacco-free. Fortunately, there are a number of resources and tools that can help.
- The National Institute on Drug Abuse — Resources for families
- Find the nearest Drug Take-Back Site where you can dispose of unused prescriptions.
- Al-Anon family groups — 1-888-425-2666
- Nar-Anon family groups — 1-800-477-6291
- Prescription Opioids: What you need to know
Immediate assistance
- Poison Control — 1-800-222-1222
- Veterans Crisis Line — 1-800-273-8255 and press 1
- National Suicide Prevention Lifeline — 1-800-273-TALK
Help quitting
Tobacco: Smokefree.gov provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.
Alcohol: Alcoholics Anonymous — 1-212-870-3400 is open to anyone affected by an alcohol-related disorder. There are no age or education requirements.
Drugs: Narcotics Anonymous is an international, community-based association that provides a recovery process and support network for those affected by substance abuse disorders.
Nutritional Resources: ChooseMyPlate.Gov provides valuable information on healthy eating.
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Website last updated: 6/24/2024
