Affordable Care Act
In the past people relied on family doctors for everything from broken bones and the common cold to the delivery of babies. Family practitioners knew the medical history of the entire family because they treated both the children and the parents.
Today many doctors are specialists, focusing on the care of specific bodily systems. But general practitioners, internal medicine doctors and family medicine doctors are still carrying on the tradition of the old family doctors.
Many health insurance plans today – especially HMO (Health Maintenance Organization) plans require members to choose a primary care physician (often called a PCP). Since major provisions of the Affordable Care Act (also known as “Obamacare”) were first rolled out in 2014, the popularity of HMO-style plans has increased. As a result, more and more consumers are choosing primary care doctors and getting at least a little taste of the old family medicine model.
A primary care doctor under an HMO plan will typically be your first point of contact for all your health issues. When you need care from a specialist physician, your primary care physician will generally refer you to specialists within your health insurance plan’s provider network.
Consumers covered under any type of health insurance plan may select a primary doctor as their main point of contact for all medical care. But only people enrolled in Health Maintenance Organization (HMO) plans are typically required to officially designate a specific doctor as their primary care physician.
People enrolled in Preferred Provider Organization (PPO) plans , POS (Point of Service) plans, or EPO (Exclusive Provider Organization) plans typically are not required to officially designate a primary care physician.
Since 2014 the popularity of HMO-style plans has increased significantly, while the popularity of PPO-style plans has decreased. This means that more and more Americans are being required to choose primary care doctors.
There are many specialties in medicine, but typically only four qualify as PCPs. These include:
Choosing a doctor can be challenging. You might not want to just pick a name out of the phone book. If your insurance plan requires you to choose a PCP, however, you may want to take time to research your options. Here are some ideas to get you started:
Don’t wait until you get sick to choose a PCP. Primary care physicians typically prefer to see their patients regularly and look for symptoms a patient may not notice.
For example, a routine health exam may uncover conditions such as high blood pressure or even hormonal imbalances due to glandular problems. Health problems like these can go unnoticed by the patient for years and could result in serious chronic health issues. Annual exams may help your PCP guide you toward healthy lifestyle habits that may decrease the likelihood that you’ll need expensive specialty care.
Developing a relationship with your primary care physician can help keep illnesses at bay. Remember the old adage: An ounce of prevention is worth a pound of cure.
To ensure that you have the right coverage before seeing a doctor, let us help to find the right health plan for you. Enter your zip code where requested on this page to see a personalized health insurance quote.