Benefits Overview

Here is a summary of the benefits you get as an Amerigroup member:

Primary Care

Maintaining good physical health is important. With Amerigroup, you go to one main person for your health care. He or she can be a doctor, a nurse practitioner or a physician's assistant. This person is called your Primary Care Provider or PCP. Amerigroup has a network of doctors and nurses who assist our members. To find a provider in your area, use the Find a Provider link above.

Behavioral Health

Amerigroup has a network of physicians, therapists and counselors who can help you or a family member with problems like depression, anxiety, family issues and alcohol or drug abuse. To find a provider in your area, use the Find a Provider link above.

All services and treatment are private. You do not need a referral from your PCP to get these services.

Pharmacy

Amerigroup has a list of drugs you or your doctor can choose from. This list is called a formulary. The formulary lists covered medicines. The covered medicines include prescription and certain non-prescription (over-the-counter) medicines.

You can get prescriptions filled at pharmacies in the Amerigroup network. To find an Amerigroup network pharmacy, use the Find a Provider link above. If you do not know if a pharmacy is in the Amerigroup network, ask the pharmacist. You can also call Member Services for help.

In addition to the over-the-counter products covered on our formulary, we offer an over-the-counter drug benefit. Members can get certain products from any Amerigroup network pharmacy that takes part in this benefit.

  • Medicaid members: up to $10 per month

Dental Care

Regular preventive dental care is the best way to fight and prevent gum disease and cavities.

For Medicaid, eligible children under age 21 may go to any dentist who accepts Medicaid. Your child’s Gold card will let him or her get this care. Your child does not need prior approval from Amerigroup. Adults age 21 and over can get medically needed emergency dental care. Please see our Member Handbook to find out more.

Vision Care

Amerigroup members don’t need a Primary Care Provider (PCP) referral for medically needed eye care benefits. Vision services include:

  • Eye exams
  • Glasses
  • Contact lenses if medically needed

Amerigroup offers our members:

  • $100 (max. amount) a year for contact lenses and contact lens service (21 years and older)

Need help finding an eye doctor? Go to the eyeQuest website or call eyeQuest toll free at 1-855-418-1627 (TTY 1-800-855-2880).

Disease Management

We have designed several programs to help you better understand and care for your chronic condition. They include:

  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Congestive Heart Failure (CHF)
  • Coronary Artery Disease (CAD)
  • Depression
  • Diabetes
  • HIV/AIDS
  • Hypertension
  • Schizophrenia

If you have one of these conditions or want to know about the other programs we offer, call Member Services at 1-800-600-4441 (TTY 1-800-855-2880) and ask to speak with a Disease Management Care Manager. Disease Management Care Managers are Licensed Nurses or Social Workers that provide coaching, coordinate services and also teach you how to manage your chronic condition. We can also help you find local community support groups and events near you.

Rides Assistance

You can get transportation to and from your medical and dental appointments.

Medicaid members can call their Community Transportation Coordinator. Please see our Member Handbookfor phone numbers to call to get transportation in your county.

If you have an emergency and need transportation, call 911 for an ambulance.

Extra Benefits

As an Amerigroup member, you also get some extra benefits, including

  • 24-hour Nurse HelpLine
  • health education classes
  • Taking Care of Baby and Me®, a program for pregnant women and new moms

Medicaid members can also get

  • $100 (max. amount) a year for contact lenses and contact lens service (21 years and older)
  • $10 over-the-counter drugs and first aid supplies benefit, per month per household
  • extra $500 per year hearing aid upgrade
  • respite care services

Please see our Member Handbook to find out more.