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Search for a Provider
The most convenient method to find a doctor, hospital or other healthcare service provider in the AFMC Network is by using our provider search and custom directory tools via this website. The provider search includes the most detailed provider information available and is updated regularly.
Access to our provider search online is available 24/7, 365 days a year. The custom directory tool allows you to create your own provider directory that includes only the information you want and can be printed on demand. Or you may contact us and speak with a call center representative who can assist you in locating a provider.
Precertification of Elective Hospital Admission
When a physician determines treatment may require a hospital stay, it is the member’s responsibility to advise the physician of the need to pre-certify the service. This is called "pre-certification." If you do not obtain pre-certification, benefits may be reduced or denied which could result in higher out-of-pocket costs. Charges for any services excluded under the health insurance plan are the responsibility of the patient/insured.
Please be certain to verify the specific precertification guidelines with your plan administrator, insurance company and/or your human resource/benefits representative. Refer to your ID card for the contact information, which is usually located on the back of the card. Remember: AFMC does not verify benefits or eligibility. |
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Pre-existing Condition Insurance Plan
In March of 2010, Congress passed and President Obama signed the Affordable Care Act - the new health insurance law. The law creates a new program - Pre-existing Condition Insurance Plan (PCIP) to make health insurance available to you if you have been denied coverage by private insurance companies because of a pre-existing condition.
The Pre-Existing Condition Insurance Plan (PCIP), which is administered by either your state or the U.S. Department of Health and Human Services, provides a health coverage option if you have been without health coverage for at least six months, you have a pre-existing condition or have been denied health coverage because of your health condition, and are a U.S. citizen or reside here legally.
This program may be able to help you, if you’ve been locked out of the insurance market, until 2014. In 2014, you will have access to affordable health insurance choices through a new competitive marketplace called an Exchange and you will no longer be discriminated against based on a pre-existing condition.
The Program:
- Covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.
- All covered benefits are available to you, even to treat a pre-existing condition.
- Doesn’t charge you a higher premium just because of your medical condition.
- Doesn't base eligibility on income.
The U.S. Department of Health and Human Services, with the help of the U.S. Office of Personnel Management and the U.S. Department of Agriculture’s National Finance Center, runs Pre-Existing Condition Insurance Plan in 23 states and the District of Columbia. The federal government contracts with a national insurance plan to administer benefits in those states. In the other 27 states, there are state-based programs. The program may vary depending on what state you live in.
Check out the State Plans page to learn more about how the Pre-Existing Condition Insurance Plan works in your state.
Eligibility Requirements
2011 Program Changes
Learn more about the PCIP Benefits
Premium Rates
The links below are pdfs. You must have the latest version Adobe Reader installed on your computer to view these files.
Convenience Clinics - An alternative to urgent care centers, convenience clinics diagnose and treat a variety of common illnesses and minor injuries for patients 18 months and older. They also offer wellness and preventive services and vaccinations.
Member ID Card 101 - Learn more about AFMC Member ID Cards and how they should be used.
Providers and Their Definitions - Definitions of different types of specialists.
Choosing Your Healthcare Provider - Tips on how to choose the best doctor to fit you and your families healthcare needs.
ER vs Urgent Care - Tips on when to visit an Emergency Room and/or an Urgent Care Center.
Guide to Health Insurance Jargon - There are many acronymns in healthcare; this tip sheet explains a few of them.
Hospital Safe Stay Strategies - Tips to help guide you and loved ones through a hospital stay.
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