Primary Care Physicians
Once you compare health insurance quotes and select a policy, you will more than likely have to choose a primary care physician. Primary care physicians are the gatekeepers to additional health services for many managed care plans. We'll explain more about their purpose and how they fit into the healthcare delivery system.
Types of Primary Care Doctors
Primary care physicians (PCPs) can come from a variety of specialties and training backgrounds. After you compare health insurance quotes and purchase coverage, you will have the opportunity to choose a PCP from the following specialties:
- Internist: a physician who specializes in internal medicine but may also have a subspecialty in another area
- Pediatrician: a provider who specializes in child healthcare
- Family practitioner: physician who is trained and certified to provide care for all family members, including children. Most family practitioners also provide reproductive health services for female patients.
- Obstetrician/Gynecologist: provider who specializes in women's healthcare. These physicians can provide reproductive health services as well as general care.
Roles of the PCP
Primary care physicians have major roles in most insurance plans, which is why you should consider the network of doctors available when you compare health insurance quotes. Here are just a few of the roles of the PCP:
- Cares for individual patients
- Manages chronic illnesses
- Diagnoses and treats minor injuries and illnesses
- Manages preventive care with wellness education and periodic screenings
- Decides when patients need to see a specialist and coordinates the delivery of care
The PCP & Managed Care
The PCP has different roles depending on which type of plan you select after you compare health insurance quotes. With HMOs, the primary care physician is a gatekeeper to specialized services. If you want to see a specialist and have the visit covered by your HMO plan, you will first need a referral from your PCP. With POS plans, you also have a primary care physician, but his/her role is not that of gatekeeper. POS policyholders are free to see any physician they like without a referral, but they will not be reimbursed at the maximum rate if they go out of network. Most PPO plans do not require policyholders to choose a primary care physician.
