Got Health Insurance Recently? Find Yourself a Primary Care Provider!

If you or someone you know recently signed up for health insurance after being uninsured for a long time, you’ve taken a major step towards improving your health.  Congratulations! Learning how to use your insurance to get healthier can be hard, especially for those of us who put our family’s needs before their own. But aren’t you worth it?

The single biggest step you can take to improve your health is to find a regular source of health care – a “primary care provider.” This could be a private doctor’s office, community health center, or other site. A primary care provider is your regular source of care, your first stop for most of your health care needs (unless you have a serious emergency).

Your primary care provider knows you and your health history and should be a partner in keeping you healthy. This is especially important if you have a family history of disease or are impacted by health disparities. For instance, African American men have a shorter life expectancy, from birth, than non-Hispanic white men. Effective primary care can reduce or eliminate this disparity.

So, you want to take care in finding a primary care provider. However, if you’ve never had insurance before, or it’s been a while since you’ve had coverage you may not know where to start.  You want to make sure that you are getting the best quality of care for the money you are spending.  Just as you would look up information on the kind of car you plan to buy to make sure it meets your expectations for quality, you should plan to research the quality of care that a primary care provider is providing to their patients.  In Greater Cincinnati we’re lucky to have an excellent resource.  Start with YourHealthMatters where you can view quality of care ratings for many local doctors. The primary care practices listed are committed to sharing their ratings and improving the quality of care for their patients.   Next, check with your insurance provider to make sure that a doctor that you select is in your “network”.

And don’t forget that community health centers (or federally qualified health centers) are also experts at providing whole-person, comprehensive primary care. Health Care Access Now (HCAN) provides a complete list of these centers for the Cincinnati area on their website.  They also assist individuals with selecting a primary care provider whether they have recently enrolled with a health plan, changed health care coverage, or are uninsured.

Once you have decided on a primary care provider and made your appointment, be sure to bring a list of questions to ask that matter to you, such as:

  • Are they accepting new patients?
  • Do they accept your insurance?
  • How long must you wait for an appointment after you call? Do they offer same-day appointments if you have an urgent need? What about weekend or evening hours? Do they have 24/7 phone access?
  • Does the office staff and doctor speak your preferred language?
  • Where is the practice located? Will it be easy for you to get there? Is it accessible by public transportation? Is there ample parking?
  • How long is the wait time in the waiting room?
  • Will you always see the same doctor?
  • How much time does the doctor usually spend with the patient?
  • Which hospital(s) does the doctor use? Are you comfortable with the possibility of being treated at one of these places should the need arise?
  • Where are routine x-rays and lab tests performed? Can these be done in-office, or will you have to go to an outside laboratory?
  • If you call with a question about your care, does a doctor or nurse return your call promptly? Do they respond to non-emergency emails?

Two good online sources for learning how to use your insurance and finding the right primary care provider are:

(1)   The Marketplace website has the resource, Roadmap to Better Care and a Healthier You. It’s in plain language and has lots of helpful information.

(2)   YourHealthMatters offers quality ratings on primary care physicians in Greater Cincinnati and information to help you become a better informed patient.

And, if you don’t have insurance, new affordable coverage is available. Depending on your income, you may be eligible for Ohio’s expanded Medicaid. You can apply for Medicaid any time. Otherwise, affordable private insurance is available through the federal Marketplace. What you pay is based on your income. Open enrollment begins on November 15, 2014 and ends on February 15, 2014.  If you recently lost your insurance, you may be eligible to enroll now through a Special Enrollment Period.  This period also allows for additional circumstances like: change in marital status, new baby, and being unemployed and not eligible for Medicaid.  Call Health Care Access Now, at 513.707.5697 or contact them at info@healthcareaccessnow.org for more information.

Here’s to your health!

Cathy Levine
Executive Director
UHCAN Ohio
clevine@uhcanohio.org

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