Practically no one likes visiting the doctor, but it’s essential to have one you can trust when the need occurs. Whether you have a different insurance plan or have never navigated the maze of private health insurance, it’s a good idea to choose one while you’re well, aren’t under a time constraint and can make an informed decision. Since you need to trust a doctor with your well-being, the decision can be very tricky. Before you choose a physician, consider these five helpful tips.
Determine What Kind of Insurance Plan You Have (if Any)
The type of insurance plan you have may determine whether or not you’re required to elect a primary care physician. American health insurance is notoriously confusing, and you may have further requirements you need to satisfy for your specific plan. There are two basic insurance plan types. A Health Maintenance Organization (HMO) plan normally requires you to designate a primary care physician through a preselected network of doctors. You would then see your primary care physician (PCP) for most of your health concerns, and that physician would issue a referral for another doctor in the same network if you need to see a specialist. A Preferred Provider Organization (PPO) plan usually does not require preselection of a primary care physician to manage your healthcare, but it’s still a good idea to see one for most general issues as they’re typically more budget-friendly than specialists.
Either way, if you do have insurance, try to stick with providers in your network. It’s much more difficult to get your insurance company to pay for out-of-network providers or services, if at all. Your insurance company should be able to provide a list of providers in your area. Call the customer service number on the back of your insurance card or consult their website for a list of participating network providers. If you don’t have health insurance, you can look for physicians who offer out-of-pocket discounts or find an affordable sliding-scale Health Resources & Services Administration (HRSA)-funded doctor or clinic.
Determine Your Priorities
Are you interested in seeing a specific type of doctor? Or are you looking for admitting privileges at a particular hospital? Some patients may feel more comfortable seeing a doctor of the same gender, one who’s board-certified or one who speaks a specific foreign language. It’s important to note your preferences, including the doctor’s overall network of care, since you need to feel comfortable with your physician and ensure you have access to their resources. If you travel far for your primary care physician, you may be tempted to forego routine visits due to a lack of convenience, which may have negative consequences down the line.
If you have children or dependents and want to all see the same doctor, a family practitioner may be right for your situation as they treat both children and adults. Internal medicine physicians usually only treat adults.
Cross-Reference a Provider on a Third-Party Site
Once you have a list of providers in your area or network, consider using a third-party site to read patient reviews or to verify information about the doctor’s credentials or practice. If you’re looking for Medicare providers, Physician Compare can help you locate in-network providers. Other helpful doctor review sites include Healthgrades, RateMDs and WebMD. Try to cross-reference a particular provider on different sites to get a better picture of their services and overall patient satisfaction.
Verify Coverage Before Your Visit
It’s a good idea to double-check insurance coverage as well as any out-of-pocket payment responsibility with your selected doctor before your visit. Insurance coverage may change year to year, doctors may switch networks and you might be unaware of any last-minute updates unless you call to verify your coverage.
Whenever you contact your insurance company, be sure to write down the call reference number (issued for customer service phone interactions with most major insurance companies) as well as the person with whom you spoke in case you need to refer back to the call at a later date.
Take Note During Your Initial Visit
While you’re at the office, take note of the staff and how they interact with other patients. Do they use a secure electronic medical record portal? Are you able to schedule a follow-up appointment in a reasonable amount of time? Does the doctor listen to you fully without interrupting? Make sure your doctor and the clinic as a whole pass a litmus test that goes beyond what you see on paper.
If you’re unsatisfied with your care, you can always keep looking for a doctor that properly suits your needs. While it’s not convenient to go through the process again, knowing that you have a good doctor and clinic when you need it most is worth the search.