You’ve just selected a new health plan, and now you may be thinking, “What do I do next?” The first step is to choose a Primary Care Provider, or PCP. This will be your “go-to” doctor or nurse practitioner whenever you need care.
Certain types of plans require you to have a PCP, like HMOs, but others do not. Whether it’s required or not, it is a good idea to choose one. Having one provider coordinate your care means that at least one person sees the whole picture when it comes to your health.
How to Find a Primary Care Provider (PCP)
If you already have a PCP, just call their office and confirm that they accept your new insurance. Then register your PCP with your new health plan. You can usually do this online or by calling the number on your health plan ID card.
If you need to choose a new PCP, ask yourself if you want to see a doctor or nurse practitioner close to home or to your office. Your health plan’s online search tool or member services department can help you find providers near you.
If you are not sure which PCP to pick, make a list of PCPs you may want to use. You can narrow your list down by providers’ quality and satisfaction ratings. Most plans have this information available online, or you can find ratings from NCQA (National Committee for Quality Assurance) and MHQP (Massachusetts Health Quality Partners). Confirm with the doctor or nurse practitioner that they accept your insurance.
Become a Patient
Now that you know who you want as your PCP, contact their office and ask if they are taking new patients. If they say no, consider asking if anyone else in the practice is accepting new patients. Or call the next PCP on your list until you find one that is accepting new patients.
Once you’ve settled on a PCP choice, make an appointment for a routine checkup right away. These types of appointments can sometimes have longer waits, and it will be much easier to make a sick appointment after you are an established patient. Finally, be sure to let your health plan know you’ve selected a PCP.