How do Empower Members get a Primary Care Provider?

Members select their PCP when they sign up for Medicaid. Members who are also eligible for Medicare are able to keep their Medicare PCP. For any members who do not select a PCP, Empower will automatically assign a PCP based on:

  • the member’s claims history (who they have seen in the past);
  • a member’s geographical location;
  • appropriate distribution by provider (so that members are not overly concentrated with the same PCP).

Members ages 18 and older will be assigned to a general or family practitioner, internal medicine, or other specialty provider approved by the state. Members under 18 years old will be assigned to a pediatrician or family practitioner. At any time, a member can call Empower Member Services and request that their PCP be changed, and Empower will honor that request if they are an In-Network provider.

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