Tips for Selecting the Right Physician and Health Care Plan
It's essential to understand the fundamentals about different types of health insurance plans to understand which physicians are available to you at the best costs. Different health plants offer different levels of flexibility and cover different amounts for in-network and out-of-network doctor's costs. To save on costs, it's typically best to choose a doctor in your network.
Health Maintenance Organization: HMOs typically allow participants to have lower out-of-pocket health care costs, but offer less flexibility in doctor choice or hospitals when compared to other insurance programs.
Preferred Provider Organization: PPOs offer doctors and hospitals at discounted rates as long as they are part of your carrier's network.
Point of Service: POS plans have some similarities to both HMOs and PPOs. In some scenarios, you are required to designate a primary care doctor who can then refer you to specialists. You can get care from out-of-network providers but will pay more for their services.
Indemnity plans: These plans offer more flexibility for managing your medical care more freely. You can see almost any doctor or visit any hospital you want. The insurance carrier pays a set percentage of your changes, and you may be required to pay up front fees and will later receive a reimbursement.
A good rule of thumb is to have a primary care physician already established before undergoing a search for a specialist. A primary care doctor can often manage an individual's overall well-being and can refer you to specialists in the need arises. These physicians are typically well-connected to the health care community and local hospitals, and they can recommend you to specialists who will better fit your needs.
It's good to come armed with questions when investigating a doctor. Here are some important ones to ask:
- Is the physician currently taking new patients and do they fall under your insurance provider's umbrella?
- What is the expected waiting period for new appointments? What is the typical length of an office visit?
- If you have an urgent situation, can the doctor see you the same day?
- Which hospital does your doctor use?
- What is the policy for appointment cancellations?
- If you are faced with a particular medical condition, does this physician have experience treating it?
Once you have made your first appointment, it's not necessary to feel obligated to stick with a doctor. There are several factors to consider before deciding to return for another appointment.
- The treatment environment: Were the office staff courteous and helpful? How crowded was the waiting area? Did other patients show signs of satisfaction with their care?
- The doctor: Did the doctor spend enough time with you? Did he or she offer enough chances to ask questions - and took the time to answer them thoroughly?
Written by Elijah Lamond
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