Navigating today's healthcare system can be complicated. If you’re enrolled in a PPO, EPO, or HDHP medical option of the Medical Plan, you can simplify your experience by accessing care navigation through Quantum Health.
Quantum Health is your primary point of contact when you have questions about your medical benefits or need help with a healthcare issue. Care navigation works seamlessly with your Medical Plan benefits:
- Speak directly with a Care Coordinator, who will get to know your needs and support you at every stage of your healthcare journey.
- Get help with managing a new chronic health condition diagnosis or complex medical issue with the help of a Care Coordinator, who works with your providers to get you high-quality, safe, and cost-effective care.
- Rely on your Care Coordinator’s clinical expertise and healthcare industry knowledge whenever you have a question about your medical benefits or are facing a healthcare decision.
- Contact Quantum Health for help with billing issues, including if you are billed at the out-of-network rate for services received at a network ancillary provider, such as an outpatient laboratory.
Contacting your Care Coordinator
Quantum Health Care Coordinators are just a call, click, or tap away.
You can call a Care Coordinator directly or schedule a call or chat live through the Quantum Health website. You can also access benefits, claims information, and more on the go through the website or mobile app.
Call: 855-497-1237, Monday through Friday, 8:30 a.m. to 10 p.m. ET
Click: myqhealthpcusa.org
Tap: Download the Quantum Health mobile app from the Apple or Google app store.
Bilingual support is available for Korean and Spanish speakers.
How can a Care Coordinator help?
Care Coordinators are well-versed in your benefits through the Board of Pensions and can assist with anything to help make the healthcare process easier, including:
- verifying covered services and benefits
- explaining the copays, deductibles, and/or coinsurance that may apply
- answering questions about a medical test or procedure
- precertifying care when required
- locating network providers, including Centers of Excellence
- answering claims or billing questions
- ordering replacement ID cards
- advocating for your care
- connecting you with the other Board of Pensions benefits and resources available
Members enrolled in Triple-S and Blue Cross Blue Shield Global Solutions (formerly GeoBlue) should refer to their plan provisions for details about their benefits and contact those plans if they have questions. Retired members enrolled in the Post-Retirement Medical Plan should call the number on the back of their medical ID card.
Questions about your other Board of Pensions benefits?
Quantum Health can help you navigate your healthcare, but we’re here to answer any questions about your income protection and retirement benefits through the Board. Call us at 800-PRESPLAN (800-773-7752) (TTY: 711) with any questions you have.