Choosing a doctor on your health plan

How do I choose a doctor with my health plan?

• If you know who you want to use, check the list of physicians your health plan provides (normally available in a printed directory and sometimes on the health plan's website).
• You can also consult a book called the Physician Directory to look up which doctors belong to the health plans you are eligible for. The book will tell you which health plans a particular doctor works with.
• Or ask your doctors for a list of the health plans they contract with.

What if the doctor I want isn't on the list?

If your doctor is not on the health plan's list, depending on their rules, you may only be able to see that doctor if you pay more (or all) of the charges for that doctor's services. Check your insurance coverage and the rules of your plan. Many doctors contract with several health plans. Use the Physician Directory to find the health plans your doctors belong to. Then, check with your doctors to confirm that they will accept the plan of your choice.

What if I don't have a doctor and don't want to "pick a name" from a list?

Many doctors are part of a medical group or IPA. Find out if your state has a listing of medical group quality ratings. If so, you can look up the doctor's name in that listing for a quality rating. Otherwise, it is always helpful to ask friends who they might recommend based on their personal experiences.