2022 Provider Directory
This directory provides a list of Johns Hopkins Advantage MD (PPO), Johns Hopkins Advantage MD Plus (PPO), Johns Hopkins Advantage MD Group (PPO), Johns Hopkins Advantage MD Premier (PPO), Johns Hopkins Advantage MD (HMO), and Johns Hopkins Advantage MD D- SNP (HMO)’s current network providers.
This Johns Hopkins Advantage MD (PPO) and Johns Hopkins Advantage MD Plus (PPO) directory is for the following counties in the state of Maryland: Anne Arundel, Baltimore, Carroll, Frederick, Howard, Somerset, Washington, Wicomico, and Worcester.
This Johns Hopkins Advantage MD Group (PPO) directory is for the following counties in the state of Maryland: Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico, and Worcester.
This Johns Hopkins Advantage MD Premier (PPO) directory is for the following counties in the state of Maryland: Montgomery.
This Johns Hopkins Advantage MD (HMO) directory is for the following counties in the state of Maryland: Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico, and Worcester.
This Johns Hopkins Advantage MD DSNP (HMO) directory is for the following counties in the state of Maryland: Anne Arundel, Howard, and Montgomery.
For any questions about the information contained in this directory (hard copy or online), please call our Customer Service Department Oct. 1 through Mar. 31 - Monday through Sunday, 8 a.m.to 8 p.m. and Apr. 1 through Sept. 30 - Monday through Friday, 8 a.m. to 8 p.m. You will need to leave a message on weekends and holidays.
• PPO Members: Call 1-877-293-5325 (TTY: 711)
• HMO Members: Call 1-877-293-4998 (TTY: 711)
In accordance with section 504 of the Rehabilitation Act of 1973 (45 CFR Part 84), this material can be made in alternate formats. Contact Customer Service to request this material in an
alternate format.
Introduction
Johns Hopkins Advantage MD (PPO) Network
This directory provides a list of Johns Hopkins Advantage MD (PPO)’s network providers. To
get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).
The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Other
physicians/providers are available in our network.
Out-of-network providers are under no obligation to treat Johns Hopkins Advantage MD (PPO) members, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization
determination before you receive the service. Please call our Customer Service Department at 1- 877-293-5325 Oct. 1 through Mar. 31 - Monday through Sunday, 8 a.m. to 8 p.m. and Apr. 1 through Sept. 30 -Monday through Friday, 8 a.m. to 8 p.m. You will need to leave a message on weekends and holidays. TTY users should call 711. You may also refer to your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
If a non-network provider sends you a bill
There may also be times when you get a bill from a provider for the full cost of medical care you received. If that happens, you should not pay the bill, but should submit it to Johns Hopkins Advantage MD (PPO) for processing to determine if you have any liability. We will review that bill and decide whether the services should be covered. If we decide that they should be covered, we will pay the provider directly.
Emergency Care
A medical emergency is when you suddenly feel very sick or have severe pain. If you believe that your health is in serious danger, or you are concerned that you may have experienced serious damage to an organ or part of your body, seek medical care immediately by heading to the nearest hospital emergency room or by dialing 9-1-1 for an ambulance. Some examples of a medical emergency are:
• Major injury such as a broken leg or a large wound
• Heart attack symptoms: severe chest pain, shortness of breath, sweating, and nausea
• Heavy bleeding
• Bleeding during pregnancy
• Major burn
• Unconsciousness
• Difficulty breathing
• Poisoning
• Severe head pain or dizziness
A list of participating network hospitals that provide emergency coverage and post-stabilization care are included in this directory. Emergency services from network providers or from out-of- network providers are covered in your plan.
If you have a non-life threatening emergency, and cannot contact your primary care physician (PCP), please go to your nearest Urgent Care Center.
With Johns Hopkins Advantage MD (PPO) plans, it may cost more to get care from out-of- network providers, except in an emergency or urgent care situation.
What is the service area for Johns Hopkins Advantage MD (PPO), Johns Hopkins Advantage MD Plus (PPO), Johns Hopkins
Advantage MD Group (PPO)?
The counties in our service area are listed below.
Anne Arundel, Baltimore, Carroll, Frederick, Howard, Somerset, Washington, Wicomico, and Worcester.
What is the service area for Johns Hopkins Advantage MD Premier (PPO)?
The county in our service area is listed below.
Montgomery.
How do you find Johns Hopkins Advantage MD (PPO) providers in your area?
If you have questions about Johns Hopkins Advantage MD or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-293-5325. Oct. 1 through Mar. 31 - Monday through Sunday, 8 a.m. to 8 p.m. and Apr.1 through Sept. 30 - Monday through Friday, 8 a.m. to 8 p.m. You will need to leave a message on weekends and holidays. TTY users should call 711. You can also visit www.hopkinsmedicare.com.
Johns Hopkins Advantage MD (HMO) Network
This directory provides a list of Johns Hopkins Advantage MD (HMO) and Johns Hopkins Advantage MD D-SNP (HMO)’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).
The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term "PCP" will be used throughout this directory. Generally, you must get your health care services from your PCP. If the health care services you need are outside of your PCP's scope of practice, your PCP will coordinate a referral to a network specialist listed in this directory. Please refer to your Evidence of Coverage for more information on the types of services that require a referral from your PCP.
You must use network providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers, neither Medicare nor Johns Hopkins Advantage MD (HMO) or Johns Hopkins Advantage MD D-SNP (HMO) will be responsible for the costs.
If a non-network provider sends you a bill
There may also be times when you get a bill from a provider for the full cost of medical care you received. If that happens, you should not pay the bill but should submit it to Johns Hopkins Advantage MD for processing to determine if you have any liability. We will review that bill and decide whether the services should be covered. If we decide that they should be covered, we will pay the provider directly.
Emergency Care
A medical emergency is when you suddenly feel very sick or have severe pain. If you believe that your health is in serious danger, or you are concerned that you may have experienced serious damage to an organ or part of your body, seek medical care immediately by heading to the
nearest hospital emergency room or by dialing 9-1-1 for an ambulance. Some examples of a medical emergency are:
• Major injury such as a broken leg or a large wound
• Heart attack symptoms: severe chest pain, shortness of breath, sweating, and nausea
• Heavy bleeding
• Bleeding during pregnancy
• Major burn
• Unconsciousness
• Difficulty breathing
• Poisoning
• Severe head pain or dizziness
If you have a non-life threatening emergency, and cannot contact your primary care physician (PCP), please go to your nearest Urgent Care Center.
With Johns Hopkins Advantage MD (HMO), you will be responsible for the full cost of out-of- network care, except in emergency or urgent care situations.
What is the service area for Johns Hopkins Advantage MD (HMO)?
The counties in our service area are listed below.
Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico, and Worcester.
What is the service area for Johns Hopkins Advantage MD D- SNP (HMO)?
The counties in our service area are listed below.
Anne Arundel, Howard, and Montgomery.
How do you find Johns Hopkins Advantage MD (HMO) providers in your area?
If you have questions about Johns Hopkins Advantage MD (HMO) and Johns Hopkins
Advantage MD D-SNP (HMO) or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-293-4998. Oct. 1 through Mar. 31 - Monday through Sunday, 8 a.m. to 8 p.m. and Apr. 1 through Sept. 30 - Monday through Friday, 8 a.m. to 8 p.m. You will need to leave a message on weekends and holidays. TTY users should call 711. You can also visit www.hopkinsmedicare.com. Johns Hopkins Advantage MD recommends verifying your provider’s network status regularly and especially before receiving services. It is important to verify because providers can opt out of the plan at any time throughout the year.
