Finding the Right Health Care Provider Requires Research & Planning
BCBS Member Resources
Whether you’re new to Blue Cross Blue Shield insurance, recently moved or are just ready for a change, selecting a primary care physician is an important first step toward managing your healthcare. Your primary care doctor is your medical “home.” It’s the doctor you visit for most medical needs, including wellness visits and routine screenings, non-emergency illnesses like earaches and sore throats, and the person you speak to about your health questions and concerns. If you have an HMO, your primary care physician will also be the person who refers you to see a specialist.
Some patient-primary care relationships can span decades, while others will be short-lived because you change insurance or move. No matter how long you plan to see your primary care physician, the relationship is an important one. You’ll want to select someone you feel comfortable having honest conversations with, someone with expertise in the areas that meet your health needs, and someone who is “in-network” for your health insurance plan. The Blue Cross Blue Shield Association National Doctor and Hospital Finder, our provider directory, can help you to narrow your search.
Here are five tips for choosing a new primary care physician:
1. Determine Which Doctors Are “In-Network”
Most health plans have negotiated special, discounted rates with certain doctors and hospitals in your area, and you will pay less out of pocket for visiting those doctors, who are called "in-network" for insurance purposes. Ensuring that you select an “in-network” doctor will help you avoid a surprise “out-of-network” charge or having to pay in full out of pocket because the doctor you’ve selected doesn’t accept your insurance plan. Check our directory to find an in-network doctor in your area.
2. Find a Doctor with Expertise that Meets Your Health Needs
Now that you have the list of in-network doctors, you can begin narrowing it down. There are several different types of doctor that will be identified as a primary care physician - typically Family Practice, Internal Medicine or General Practice. There are also doctors who focus on children, called Pediatricians, who will serve as the primary care physician for your child.
- Family Practice – Family practice physicians are able to treat patients of all ages, from newborns to the elderly. They are generalists who can treat a wide variety of conditions, and often can also treat ailments you’d normally see a specialist for, like sports injuries or some women’s health needs.
- Internal Medicine – Internal medicine physicians typically treat adults and specialize in the prevention, diagnosis and management of disease and chronic conditions.
- General Practice – General Practice physicians are like family practice physicians and can treat patients of any gender or age. This category is one area where you might also find osteopaths, which are physicians that practice a type of alternative medicine with special focus on the musculoskeletal system, and are distinguished by the “D.O.” after their name instead of “M.D.”
Consult our online directory to find in-network family practice, general practice or internal medicine providers.
3. Ask for Referrals
Many people feel most comfortable visiting a physician who is recommended by someone they know, like a family member, co-worker or friend. Ask around and see what doctor your friends and family visit. You can also ask another healthcare professional with whom you have a relationship, like a women’s primary care physician, a pharmacist, or even your dentist for a recommendation. If you’re moving, ask your current doctor if they have a recommendation for your new location.
4. Think About Logistics
Do you want a doctor located close to your home or office? Search for doctors with an office location that is convenient for you to visit. You’ll also want to consider office hours – what days and times does the doctor see patients? Will you need to take time off work to visit the office, or can you go after work or on weekends? It’s also a good idea to check what hospital the doctor admits patients to.
Language is another important factor to check. You need to be able to communicate clearly with your doctor, so check which languages he or she speaks to be sure you’ll be able to understand each other. Many doctors now use email or an online portal to communicate with patients, which may be another item of importance to tech-savvy communicators when selecting a physician.
Consult our provider finder's "advanced search" feature to find in-network doctors who speak Spanish or other languages.
5. Visit the Doctor
Nothing can really give you a feel for whether you’ve selected the right doctor like an office visit and a face-to-face meeting. Be sure you feel comfortable in the office and with the physician and nurses. Your primary care physician should be someone you trust and can rely on to help manage your healthcare. Talk with him or her about any current medications you are taking and your medical history to be sure you are on the same page when it comes to managing any chronic conditions.
When in the office, you should evaluate other environmental factors. Take into account the demeanor of the people who answer the phone and greet you when you walk in – are they efficient and friendly? Are the phones answered in a timely manner? How far in advance do you need to schedule an appointment? And how long is the wait to see the doctor after you arrive for your appointment?
If for any reason you are not happy with your choice, most Blue Cross Blue Shield plans allow for you to change your primary care physician anytime during the plan year. Call the number on the back of your member ID card for more information, or find your local BCBS company's website.