Choosing the right provider is one of the most important decisions you’ll make about your health care, and finding the right one can take a little work.
Remember, you’re looking for a partner you can trust and work with to improve your health and well-being, so take time to think about what you need. Depending on how complicated your health care needs are, you may need to see more than one type of provider. Two common provider types are listed below.
A Primary Care Provider is who you’ll see first for most health problems. They will also work with you to get your recommended screenings, keep your health records, help you manage chronic conditions, and link you to other types of providers if you need them. If you’re an adult, your primary care provider may be called a family physician or doctor, internist, general practitioner, nurse practitioner, or physician assistant. Your child or teenager’s provider may be called a pediatrician. If you’re elderly, your provider may be called a geriatrician. • In some cases your health plan may assign you to a provider. You can usually change providers if you want to. Contact your health plan for how to do this.
A Specialist will see you for certain services or to treat specific conditions. Specialists include: cardiologists, oncologists, psychologists, allergists, podiatrists, and orthopedists.
You may need a Referral from your primary care provider before you go to a specialist in order to have your health plan pay for your visit. For some services, your health plan may require you to first get Preauthorization — a decision by your coverage or health plan that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary and will be covered. This is also called prior authorization, prior approval, or precertification.
The right provider
It might take more than one visit to figure out if a provider is the right one for you.