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When you sign up for new health insurance coverage, it’s extremely important
to select the best primary doctor for you and your health plan. Not only do you
want to select a competent, experienced doctor who will provide you with
exceptional medical care, but you also need to ensure that he or she will
provide health care services as specified under your insurance policy.
Although you may be tempted to simply choose the doctor with the office
closest to your work or home, you should not take this decision lightly.
Choosing the best doctor requires a great deal of research. Take the time to
look into your potential doctor’s credentials and find out how well they work
with your specific type of insurance plan. After all, your physical and
financial health could depend on it.
Different plans, different doctors
If your health insurance plan is an HMO or PPO, you’ll probably be limited
in your choice of doctors. These plans typically provide a list of “network
approved” doctors from which you can choose your primary physician.
However, you can usually choose someone outside of your health plan’s
network at an additional cost. If you can’t find a suitable doctor within your
network, it may be worth the extra expense to do this.
Pinpointing the best doc
Here are a few steps you can take to find the most appropriate doctor for
your unique healthcare wants and needs:
- Get recommendations: Ask
friends, family members and coworkers if they can recommend a doctor. If
people you know and trust have been happy with a doctor’s care, the odds
are that you’ll be satisfied too.
- Consider going out of
network: Even if a friend recommends a doctor who is outside of your
health insurance network, you should add that doctor to the list of
“approved” doctors you are considering. Check into all of these doctors—it
may be worth the higher price tag to use an out-of-network doctor if no
one within the network suits your needs.
- Research credentials: Once
you have a list of potential doctors, call each doctor’s office and
inquire about their education, training and experience. You may also want
to ask about specific qualities that you are seeking in a doctor. For
example, if you prefer a woman as opposed to a man, a doctor of a certain
age or religion or even a doctor who attended a certain type of school,
you should ask all of these questions.
- Check with medical
associations: You may also consider finding more information about
potential doctors from the American Board of Medical Specialties (ABMS) or
The American Medical Association (AMA). These associations offer
professional information about doctors throughout the country. Visit the
ABMS website at www.abms.org and the AMS
website at www.ama-assn.org/aps.amahg.
- Find out if they’re board
certified: Although doctors are not required to be board certified,
this is important to some patients. Doctors have to complete additional
years of training in a specialty and pass an exam in order to be board certified.
You can call the ABMS at 1-800-776-2378 or visit their website at
www.abms.org learn more about board certification.
- Learn about complaints: You
may also want to contact your state department of insurance to find out if
any complaints have been filed against your potential doctor.
- Meet face-to-face: Once
you have narrowed down your list of doctors, you should set up an
introductory appointment with each of them. Although some offices charge a
small fee for these types of visits, it’s well worth it. This will allow
you to get a feel for the doctor’s personality and ask him or her
questions first-hand.
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