Content Overview 
- Summary
- Be An Active Patient
- Learn About Your Plan
- Choose A Primary Care Physician (PCP) With Care. Get To Know The PCP And About Potential Conflicts Of Interest. Learn How To Get What You Need From A PCP
- Choose Specialists With Care
- When Choosing Other Medical Care Providers, Make Sure The Provider Is Still In Network.
- Connect With Case Management
- If You Think You Need A Second Opinion, Ask For One
- If Your Plan Covers Mental Health, Take Advantage Of It
- Learn What To Do In The Event Of A Medical Emergency
- Minimize Out Of Network Costs. For example, if You Agree To Surgery, Make Sure All Members Of Your Surgical Team Are Part Of Your HMO.
- If you need surgery, make sure all members of the team are part of the HMO.
- When Drugs Are Prescribed, Look For The Alternative On The Formulary With The Least Out-Of-Pocket Expense
- Learn What To Do If A Drug Or Treatment You Want Is Denied Or If You Have Other Complaints Against The Insurer
- Keep Your I.D. Card With You In Your Wallet Or Purse
- How To Keep Your Doctor When You Change Health Plans
- Insurance Policies Are Not Set In Stone. Negotiate.
- If You Don't Get What You Want, Appeal. Appeal. Appeal.
Summary
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- Be an active patient.
- Learn about your plan. Know what you're entitled to instead of relying on someone who isn't as interested in your health as you are to tell you.
- Choose a Primary Care Physician (PCP) with care. Get to know the PCP and about potential conflicts of interest. Learn how to get what you need from a PCP.
- Choose specialists carefully.
- Use in network doctors and other health care providers as much as possible.
- If you want to use out of net work doctors and other health care providers, learn how to minimize the amount you have to pay.
- Make sure you don't use out of network providers without knowing it. For example, If you agree to surgery, make sure all members of the surgical team are part of your provider's network.docthe person is still part of the network. If
- Connect with case management.
- If you think you need a second opinion, ask for one.
- If your plan covers mental health, take advantage of it. You can always discontinue if it's not helpful.
- Learn what to do in the event of a medical emergency.
- When drugs are prescribed, look for the alternative that is on the formulary and that has the least out-of-pocket expense.
- Learn what to do if a drug or treatment you want is denied or if you have other complaints against the Insurer.
- Get help dealing with the insurance company if you need it.
- Carry your i.d. card with you in your wallet or purse.
- Learn how to keep your doctor if you change health plans.
- Keep in mind that insurance policies are not set in stone - negotiate.
- If you don't get what you want, appeal. Appeal. Appeal.
To Learn More
More Information
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