Are you moving your health insurance to a different carrier and don’t have access to your normal primary care physician? Are you moving out of town and need to find a new doctor? These are some tips to help you do just that.
One of the saddest moments of being a broker is when a client asks; “This plan is great – the prices are fantastic and the employees love it, but I heard that they no longer have Doctor X in their network and one of my employees has always gone to Doctor X. I understand that the employee chose to go with an HMO instead of a PPO (which would have included Doctor X in the out-of-network); would you be able to help them find a new physician?” This moment always causes a bought of empathy, and I am sure it is a universal feeling. This problem has actually been much more prevalent since the Affordable Health Care Act, so it is now more imperative than ever to have a solution or at least steer the employee into the right direction instead of them possibly getting lost and unable to find a good doctor. The great news is that many carriers understand the need for relevant information for their members, and they are making their websites more user-friendly and comprehensive.
Steps to Finding a Primary Care Physician
Finding a primary care physician can easy, especially if you just listen to your neighbors or coworkers when they tell you that “so and so was the best doctor ever!”, but by simply going to your carriers website, you should be able to find their primary care physicians with a few clicks of the mouse. Most carriers these days have links on their home sites that direct you to a provider portal where you can find all of their in-network primary care physicians, and this portal normally gives you the ability to have very advanced searches to find physicians near you, to see if they are in your specific policies’ network, to see which hospitals are in your preferred providers network, and to find out if the primary care physicians are either too booked to see more patients or are ready to accept new members.
Broker Tip: It is best to pick a primary care physician that is near your location; some insurance carriers will limit the distance the primary care physician can be from your residence or place of employment. Contact your HR person or your insurance carrier and ask if they have any restrictions or limitations regarding this subject.
Ways to make sure You are in the Clear
Websites may not be the most up to date solution, so once you do find a primary care physician that you like, you should contact their office using the number provided on the carrier’s provider portal and see if that primary care physician is contracted with your insurance carrier under your policies network and if they are indeed booked or looking for new patients. It is always better to be safe than sorry; it is best to go the extra mile to avoid any headaches.
Make sure you find Your Primary Care Physician before your Enrollment date
If your enrollment date is coming up, it is best to know which primary care physician you are going to choose because some carriers, if you don’t choose your own primary care physician, will choose it for you. It is also good to write down as much as the information as you can related to the doctor to fill out the enrollment form, so first and last name, any identification numbers, and any unique items related to the doctor that you think could help (any extra information could help you if you had to choose between doctors and you talked to the enroller regarding them. Remember, information is power).
Be Happy with Your decision and get ready to make a new Relationship
Meeting your new doctor may make you a bit nervous, but the process for finding them shouldn’t!
I hope you have learned a few good tips for finding a primary care physician, and I wish you luck on your health care endeavor. Have a great day, and thank you for reading!
Additional Disclaimer – Although I am an Insurance broker and a professional in the field, the Health Care laws are ever changing, especially in the age of the Affordable Health Care Act, and the laws, information, opinions, or understandings that I have wrote about may be obsolete by the time you come across them and I take no legal responsibility for what actions you may or may not take because of it. To keep yourself safe, please seek updated professional advice, because changes are happening and I would like to keep everyone safe from any misleading or dead information. Please check out the “Terms and Conditions” page for more information and/or bookmark my blog for upcoming changes and updates to the ACA. Thank you for reading, and have a great day!