Member FAQs

PCP means Primary Care Physician. Physicians, and nurse practitioners or physician assistants, of the following specialties are PCPs: pediatrics, general practice, internal medicine and family practice. HMO members must select a PCP or one will be chosen for them.

Teenagers will need to change PCP’s as they move from pediatric care to adult care. A family practice practitioner will need to be selected as the new PCP when the teenager moves out of his/her pediatrician’s care. Visit Got Transition (https://www.gottransition.org/youth-and-young-adults/) for more information about moving from pediatric to adult care.

Your PCP copay. A GYN is not considered a specialist. Routine preventive GYN visits are covered 100%.

Yes. We must list a PCP for each member in order to have all information necessary for our members. You do not have to notify us if you use another PCP occasionally, only if you have elected to stop using your listed PCP and begin using another PCP regularly.

Teenagers will need to change PCP’s as they move from pediatric care to adult care. A family practice practitioner will need to be selected as the new PCP when the teenager moves out of his/her pediatrician’s care. Visit Got Transition (https://www.gottransition.org/youth-and-young-adults/) for more information about moving from pediatric to adult care.

Copays are listed on your Member ID card or Cost Share Schedule. You can contact Member Services at 318-361-0900 or 1-888-823-1910 to check the status of your deductible.

Copays vary by plan. Copay amounts are listed on your Member ID card, in your plan documents, or are available by calling our Member Service department.

Vantage's Member Service and Health Risk Management departments are able to answer questions regarding prescription drugs. Vantage can be reached at (888) 823-1910. Saint John Pharmacy can be reached at (888) 316-4354 with any mail order prescription questions.

Pre-authorization is needed for any inpatient/outpatient stay or Major Diagnostic test. For a complete list of procedures that require pre-authorization, please refer to your Certificate of Coverage or Evidence of Coverage. You can also call Member Services at (888) 823-1910 for information about services that require pre-authorization.

Vantage’s Medical Management department will work with your provider to complete pre-authorizations as required by your plan. Medical Management can be reached by calling (888) 823-1910, option 2. Additional information about Vantage’s pre-authorization processes can also be found in your Certificate of Coverage or Evidence of Coverage.

You can use the provider search utility on our website to find in-network providers or we can mail the member a provider directory. To ask about a particular provider or to request a directory, just call 318-361-0900 or 1-888-823-1910.

Copays vary by plan. Copay amounts are listed in your plan documents, in the Member Portal, or are available by calling our Member Service department.

Vantage offers plans with dental coverage. Plans offered through Healthcare.gov do include dental coverage, as well as employer group plans. Please refer to your plan documents for a complete listing of covered services for your particular plan.

We do not cover any type of weight loss procedure.