PCP Change Request Form
You can change your Primary Care Physician (PCP) at any time.
Directions for changing PCP.
- Please print the form below and fax form with a copy of your ID card, if available, to Magnolia Member Services Department at (877)-779-5219 or mail the form to Magnolia Member Services, 111 E Capitol Street, Suite 500, Jackson, MS 39201.
If you have questions about how to complete this form, please call the Magnolia Member Services Department, Monday through Friday, 8 a.m. – 5 p.m., at (866)-912-6285 (TDD/TTY (877)- 725-7753 or Mississippi Relay Service at 711).