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You are here: Home1 / Our Blog2 / All About Medicare3 / Making the most of your coverage4 / Four tips for choosing a primary care provider (PCP)

Four tips for choosing a primary care provider (PCP)

Your Health and Wellness, Making the most of your coverage
Aspire Blog - Tips for choosing a primary care provider

We talked about the importance of choosing a primary care provider (PCP) in a previous blog. A PCP coordinates your care, knows your medical history, and works with specialists in your area. That’s why it’s important to find the right one. Most Medicare Advantage (MA) plans require that you choose a provider from their network which usually includes many different local providers. Keep the following tips in mind to help you identify the best PCP for your needs.

 Tip #1: Know who qualifies as a primary care physician

A PCP is a doctor trained in a broad array of illnesses and injuries, and they can prevent, diagnose, and treat illnesses and injuries in the general population. They can also help treat long-term conditions like diabetes or acute issues like colds, and flu. There are a few different types of doctors that qualify as a primary care physician:

  • Family practice – Treats patients of all conditions and some ailments that would usually require a specialist like sports injuries and some women’s needs
  • Internal medicine – Treats adults and specializes in diseases and chronic conditions
  • General practice – Treats patients of any gender or age; may include osteopaths (alternative medicine with focus on musculoskeletal system)
  • Geriatrician – Specializes in treating older patients
  • Pediatrician – Focuses on the health of infants, children, and adolescents
  • Gynecologist – Specializes in caring for the reproductive health of women

The first step to choosing a PCP is to find the practice that best fits your needs. Make sure you search for the type of provider above who can address your biggest reasons for seeking care.

 Tip #2: Think about logistics

One of the most important factors to consider when choosing your PCP is that working with this provider is easy for you. Before you begin treatment, here are a few logistics to consider:

  • Location – Look for a provider that will be close enough for you to get to. Great recommendations for a PCP can come from your trusted network of family and friends. If you’re new to the area, you can find a list of doctors by searching for “primary care near me” online. Work with your Medicare Advantage plan to get a list of great providers in your network.
  • Communication – Make sure that the way the doctor communicates will help you get the care you need. Before you start treatment, ask how you can schedule appointments and receive reminders. If you prefer online communications, choose a doctor who uses an online portal like MyChart. If you prefer phone calls or reminder cards, ask if the doctor provides them. Make sure the doctor can communicate with you in the language with which you are most comfortable.
  • Availability – Will the doctor be available when you need them? If you discover that your next appointment is months away, but you need treatment right away, this doctor may not be a good fit.
  • Specialties – If you have any preexisting conditions, make sure your doctor has experience in treating them. You can also make sure that your doctor has experience treating patients in your age range.

Find a primary care provider who works for you! The best primary care provider is the one who has the best combination of a good location, communication, availability, and expertise.

Tip #3: Find someone in your network

There are a few ways to figure out if a PCP is in your network. Medicare.gov provides a physician comparison tool to enter your location and the type of doctor you’re looking for to learn more about the ways their office will charge for your treatment. You can also call the office and ask if they accept Medicare or a Medicare Advantage plan, like Aspire Health Plan, in Monterey County

Most Medicare Advantage HMO and HMO-POS plans have a network of providers from which to choose from to help coordinate and personalize your care. While there’s a common myth that these plans force you to see a small group of providers, networks like Aspire Health Plan’s include over 700 doctors and all four Monterey County hospitals. Use our “Find a doctor” tool to search for providers using first name, last name or specialty.

Tip #4: Make a personal connection

Finally, there is no substitute for making a personal connection with your doctor. Before your first visit, you can call or visit the office. The first phone call with the office can tell you a lot about how friendly their staff will be, how busy the office is, and what the wait time for an appointment will be. If you are able, visiting the office is a good idea. You may even be able to talk with the doctor beforehand to ask any questions about their experience or treatment methods.

If you have any questions about finding a primary care provider, we’re here for you! Call us or leave your question in the comments section below.

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