Who doesn’t like the chance to get high quality at a discounted price? But did you know that many Premera plan members have this same opportunity when seeing a doctor?
By designating one doctor as your primary care provider (known as a “PCP”), you get a “quarterback” for your health plus a financial break with each office visit. That’s because your PCP will get to know you very well. They will have a full view of your health history, make sure you get recommended preventive care, and manage illnesses and ongoing conditions. And you get a lower co-pay with each PCP visit.
With Premera, you can choose a PCP from many types of healthcare providers—family or general practice doctor, internist, pediatrician, obstetrician/gynecologist (OB-GYN), physician’s assistant or nurse practitioner.
PCP selection is part of all Premera individual and family plans (except for HSAs), and many group plans. Call customer service using the number on the back of your ID card to find out if your plan includes this feature.
Go With Who Knows You Best
As a guideline for picking a PCP, ask yourself who can best monitor and help you maintain your overall health.
“To get the highest value of care, you should designate the doctor that will treat you 90% of the time,” says Dr. Ted Conklin, Premera’s medical director of clinical innovation. “With a PCP, they monitor your health and preventive screenings, and help you seek out the right specialist should there be a change in your medical condition, such as seeing an OB-GYN when you are pregnant or a dermatologist for skin cancer concerns.”
Make Your Choice ‘Official’
Call customer service to let your health plan know your selection. That way, for each visit to your PCP, you get a lower co-pay, which can be less than half the cost of visiting a non-PCP doctor. If your PCP is part of a medical practice with other doctors, you still can get the discount by seeing another doctor in their office.
Other factors to keep in mind when making your decision:
Know Your PCP’s Hospitals
Should you be admitted to the hospital, your PCP will work closely with hospital staff. So make sure you’re OK with the hospitals and facilities your PCP is associated with for surgeries or treatments. (Check our tips for finding a doctor, hospital or facility.) For example, if you have an accident and break your leg, your doctor may consult with the hospital staff to arrange for an orthopedic doctor for your follow-up care and recovery.
Make Individual Selections
Family members each can have a different PCP. For example, a child may have a pediatrician, mother an OB-GYN, and dad a naturopath – whatever makes most sense for each member. Alternatively, you and your family may feel most comfortable having the same family medicine provider.
“As you establish a relationship with your primary care doctor, think about how you like to interact with him or her,” Dr. Conklin says. “There should be an element of chemistry and trust knowing that they have your total care in mind.”
Switch PCP if Needed
Finally, keep in mind that you can change your PCP if needed. Just make sure to notify your health plan and ask that your records be transferred to your new doctor before your initial visit. That way your initial visit with the new PCP is more productive, setting you up for the consistency of care you want in the long term.
