Pick a Plan, Find a Doctor

Pick a Plan, Find a Doctor

If you are one of the millions of Americans who recently enrolled in health insurance for the first time, good for you! Enrolling in health insurance was one of the most important things you did this year. Now that you are covered, there’s a big next step you need to take right now. That’s to find a doctor who is right for you. Let’s walk through how you do it:

1. Know what types of doctors you’re looking for

If you don’t already have one, you’ll want to find a general practice doctor and set up a first visit. This doctor may be a family practice or general internal medicine doctor. For the kids, you can use a pediatrician. If you are a woman, you can even use your gynecologist. You’ll need a doctor who can do a thorough checkup to check for any health issues that may need treating.

If you have an HMO plan, this doctor will be your primary care physician, or PCP. You should have picked a PCP when you enrolled. If you didn’t, we would have assigned one to you. If you have a PCP but want to change to another doctor, you can call Customer Service at the number listed on your member ID card. You can also register and log in to your account on Blue Access for MembersSM and select “Change PCP” from the Doctors & Hospitals section.

Your PCP will track your care and even help you find a specialist, such as a heart doctor or surgeon, if you need one. You’ll additionally want to make sure any specialist you see or hospital you visit is in your network. Without a referral from your PCP to a network specialist, you could end up paying the full cost of your care by the specialist.

2. Know where to look within your health plan

Your health plan has a certain group of doctors you can choose from. It also has a list of hospitals, clinics and other medical services you can use. This is your plan’s provider network. These providers have agreed to see our members who have that plan. The network agreement outlines such things as what tests and treatments we’ll cover, how much we’ll pay them for their services, and where certain medical tests or procedures can be done under your plan’s benefits. That agreement is one of the ways we protect our members from paying more for some doctors than others, and from unknown charges.

For you, this means you’ll need to find a doctor that’s in your plan’s network in order to have your visits and treatment paid by your insurance at the best rate. Networks vary from plan to plan, so make sure you know the doctors in your network for the health plan you bought. If you’re not sure, check before you go -- call Customer Service at the number listed on your member ID card or enter your plan name in our Provider Finder tool to pull up a full list. If you want to find certain types of doctors, you can search by specialties.

 provider finder

Want more tips? Check out How to Find a Doctor – The Right One.

3. Look Forward to your First Doctor Visit

Your new doctor will want you to come in and get set up as a new patient sooner rather than later. At that first visit your doctor will ask you questions about your medical history, do a physical exam, take your blood pressure, draw blood to check for diabetes and other health conditions, and maybe do cancer screenings. Even if you think you are healthy and don’t need care, a quick visit can help you know for sure, plus this first visit may not cost you anything because most preventive care is covered in full by your insurance. If you are concerned, you can always ask the doctor’s office before your visit to find out how much it will cost.

Get the most of your health plan by using it now to stay healthy, rather than waiting until you get sick. Spending a little money now to see a doctor and get the health care basics covered saves us all money down the road and could save you from a lifetime of illness.

Have you had any difficulties? Let us know below and we’ll help you!