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If you have an HMO*, you’ll need to find a primary care provider, or PCP, to be your “personal” doctor. A PCP most often focuses on general internal medicine, family medicine or obstetrics/gynecology (OB/GYN). Older adults can choose a geriatric doctor. Children can have a pediatrician.
Here are five ways having a PCP can benefit your health and well-being.
Someone to quarterback your care: Having your own personal doctor means you’ll have someone in your corner making sure you get the care you need. They’ll know your health history, any health conditions you have and what medicines you take.
More focus on staying healthy: Your doctor will provide your routine medical care such as annual exams and treatment for colds and the flu. They will also make sure you get vaccinations and screenings and talk with you about how your lifestyle might impact your health. That way you can focus on staying healthy, instead of seeking help only when you are already sick or hurt.
A trusted guide to your follow-up care: Your doctor can guide you to the best place to go when you need more care. If you need to be seen by a specialist, they can coordinate the care, especially if you need to be seen by more than one. This keeps your care on track and can help you avoid unneeded visits.
Detect and treat illness earlier: Early diagnosis and treatment can keep many common health problems from getting worse. Having your doctor manage your care means problems can be caught early before they become serious or lead to other major illnesses. For example, catching high blood pressure early and getting it under control could prevent you from having a stroke later.
Manage your conditions and care better: If you have a chronic health issue such as asthma, diabetes or a heart problem, your doctor can make sure you have access to specialized care to help keep your condition from getting worse.
To make the most of your relationship with your PCP and get the most out of your health plan, follow this advice:
Schedule that first visit now: If you’re choosing a new doctor as your PCP, schedule your first visit as soon as possible. The sooner you create a relationship with your doctor, the sooner you’ll have someone in your corner overseeing your care. And going to your new patient appointment right away will help avoid delays in getting an appointment when you’re sick or need a referral.
To each, their own PCP: Each person on your plan can pick their own PCP. Your PCP’s name and contact information will be listed on your member ID card. If you decide later your PCP isn’t right for you, you can choose a different one.
See your PCP first: It’s best to call or go to your PCP first when you need care unless it’s an emergency. Your PCP will be able to make informed choices and direct you where you need to go for further treatment. That may mean going in to see your PCP or a specialist, going to an urgent care center, or heading to an emergency room.
If you need to be seen by a specialist such as a cardiologist, make sure to start with your PCP. It’s important to get your care from providers in your network. This will help ensure you have fewer out-of-pocket expenses. Depending on your type of plan, if you get care from a provider who is not in your plan’s network, you may have to pay the full cost of your care.
To make sure a provider or facility is in your plan’s network, log in to your account and go to Find Care. You can search for the provider and location that is right for you. Depending on your plan, you may also be able to estimate the out-of-pocket costs for your tests or treatments.
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