Getting routine care from doctors

Do you need a primary care physician?

Most people have a doctor or nurse practitioner that they see when they need routine care. We refer to this person as your primary care physician (PCP). We encourage you to select a PCP in our network to manage your health care by staying informed of all your visits to specialists and other health care providers. A PCP who knows your health history is your best resource for making sure you get the right care.

When you have PriorityHMO^SM, PriorityEPO^SM or PriorityPOS^SM, you have to name a PCP for each person on your plan.

PriorityPPO^SM members are not required to name a PCP.

Choosing a primary care doctor or other primary health care provider

You should use doctors, hospitals, pharmacies, and other health care providers that have agreed to work with your Priority Health plan. Why? Priority Health gets a discount on their services, so even if you are paying "full price" - such as times before you have met your deductible - you will get the Priority Health discounted price.

Here's how to find health care providers that accept your Priority Health plan:

1. Go to the online Find a Doctor directory.
2. Choose your health plan, for example "HMO", and enter your ZIP code or town name.
3. Choose the kind of health care provider you're looking for, such as PCP or hospital.
4. Select any of the options listed (for example: PCP name, location, specialty) to narrow down your search for a PCP.

Does everyone in your family have to have the same PCP?

No. Everyone covered under your health plan can visit the same PCP, or each person can have a different one.

• PCP choices can include internists, general practitioners, family medicine, OB/GYNs or physician assistants.
• Children can have a pediatrician as their PCP.
• Women can choose some (OB/GYNs) as a PCP, but not all OB/GYNs are also PCPs.

How to change your PCP

No problem. The change will go into effect on the first day of the month following your request. To find a new PCP, use the Find a Doctor directory online. It allows you to search by specialty and by location. Once you choose a new PCP, you can:

• Use the online "Change Your Doctor" tool (you must be logged in to your account).
  OR
• Download the Change PCP form (333KB PDF), fill it out and mail it to us.
  OR
• Get the form from your employer, fill it out and mail it to us.
  OR
• Contact Customer Service and we'll make the change for you.

Getting preventive care

Preventive care services are designed to diagnose health problems early, saving you money on treatments and ensuring your overall wellness. Examples of preventive care measures are physicals and other health screenings, immunizations, x-rays, mammograms, etc.

For more detailed information and a list of covered services, see our Preventive Health Care Guidelines.