Provider Network
Our provider network includes doctors statewide that provide services to AlohaCare Plan members. You can choose a Primary Care Provider (PCP), a specialist, or other doctors within the AlohaCare provider network.
If you would like information about professional qualifications of PCPs and specialists, including medical school attended, residency completed, and board certification status, call Member Services.
A Primary Care Provider (PCP) is your main doctor and the person you visit for most of your health needs, like annual checkups, common illnesses, or managing chronic conditions. They keep track of your overall health history and coordinate your care if you need to see a specialist.
Why Having a PCP is Important
- Prevention: They help catch health issues early through screenings and vaccinations before they become serious.
- Coordination: If you need a specialist (like a cardiologist or dermatologist), your PCP often provides the referral and ensures all your doctors are on the same page.
- Familiarity: Because you see them regularly, they understand your health over the long term, which leads to better-personalized care.
You can choose a Primary Care Provider (PCP) and other doctors through the Provider Directory. The Provider Directory is a list of our network doctors.
You may also use our
Provider Finder on our website to search for providers. You can search for doctors, hospitals, pharmacies and other health care facilities that best suit your needs.
- Go to the Provider Finder tool
- Select your Plan Type and click the blue box that says "Search." Depending on your search criteria, you may not need to select a Plan Type for your search.
- You can also search for providers by their name, specialty, gender, office location (city, zip code or island), language spoken, hospital affiliation, medical affiliation and/or if the provider is accepting new patients.
To customize your search:
- Click the boxes to choose factors that meet your specific needs. You can also enter text into the search boxes.
- Click on the blue box that says "Search."
- For more information about each provider, click on "Details"
If you need to change your PCP, you can find a new one in the Provider Directory, by using the Provider Finder, or you can call Member Services, and we will help you choose. Your PCP change will take effect on the same day you call us with your change request.
Some reasons why you may change your PCP include:
- Wanting to see the same PCP as your family members
- Moving too far away from your PCP
- Having problems with your PCP or your PCP’s office staff
You can change your PCP in the following ways:
- Log into the AlohaCare Member Portal
- Contact AlohaCare Member Services
- Call Toll-free: 1-877-973-0712, TTY/TDD: 1-877-447-5990
- Use the Chat feature at the bottom of our Contact Us page
- Submit a Contact Us Form, and we will reach out to you
- Complete the Primary Care Provider (PCP) Change Form, and mail or fax the completed form to AlohaCare
If you have Medicare, you can choose any doctor or primary care provider (PCP) that accepts Medicare, and they do not need to be in our provider network. We will still cover your copayments and coinsurance, working directly with your PCP. If you are enrolled in a Medicare Advantage plan, you should continue using their specific provider network and assigned PCP without needing to select a new one.
Your Primary Care Provider (PCP) is responsible for managing your overall health and will provide a referral if you need to see a specialist or go to the hospital. To make sure your visits are covered by your plan, please talk to your PCP before scheduling any appointments with other doctors.
You will need a referral from your PCP for:
- Specialist Visits: Seeing a doctor for a specific health concern (like a heart or skin specialist).
- Out-of-Network Doctors: Seeing any doctor who is not part of our official provider network.
- Hospital Care: Any planned stays or outpatient services at a hospital.
If you have an emergency, you do not need a referral, go to the nearest emergency room or call 911 immediately. For all other care, checking with your PCP first helps you avoid unexpected medical bills.