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Girls' VersionChoosing a Primary Health Care Provider (PCP):
Health Plans and Health Care Providers
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What if I belong to a health plan?
If you belong to a health plan, your choice of health care providers may be limited to providers that are part of the plan. Sometimes you can choose to see any provider. You should check the plan's list of healthcare providers in the insurance booklet or on the insurance company’s website. Ask friends or relatives who have the same plan as you for names of their health care providers who they like.
What if I don't belong to a health plan?
If you don't belong to a health plan, your choice of providers is much greater. You may want to first think about which provider you would like to use. Check on how much a typical office visit and lab tests cost. If it doesn't fit your budget, check on public health clinics, family planning clinics, health centers, and hospital clinics. Also, check whether they have sliding scales or free care.
Is there a way I can check on a provider's qualification?
Yes, you have a few options. You can ask friends or relatives who go to the provider. You can also call the provider's office and ask the office staff about the provider's credentials. Every provider should be licensed to provide care by the state in which they work.
A way to find information on the quality of care of different providers is to visit docboard.org.
You can find out if a provider is board certified by calling The American Board of Medical Specialties at (800) 776-2378 or checking the web site abms.org. "Certified" means that the provider has finished a training program in one area of medicine and has passed an exam (board) that tests her or his knowledge, skills, and experience to provide quality care.
How do I decide on one PCP?
Once you have made of list of qualified providers, you can call their offices to ask some questions. See if you like the way the staff answers your questions. You need to find out if the provider is covered by your health plan and if he/she is taking new patients. If you don't know if the provider is board certified or what their training is, ask. Some other questions you might ask include:
- Which hospitals does the provider work in?
- What are the office hours (when is the provider available and when can I speak to office staff)?
- Does the provider or someone else in the office speak the language that I am most comfortable speaking?
- How many other providers can see me when my primary care provider is not there?
- How long does it usually take to get an appointment with my provider?
- What are the provider's fees? Do I need to pay when I am at the provider's office or will I be sent a bill?
- What do I do if I need to cancel an appointment?
- What do I do if I have an emergency or if I need medical help after-hours?
- Does the provider give advice over the phone for common medical problems?
- Can I contact my provider by e-mail?
The answers to these questions should help you decide which provider you want to handle your care. Once you like what you hear, make an appointment with that provider for a general check-up.
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Updated: 5/27/2011
