subject: Get More From Your California Health Insurance Plan [print this page] Get More From Your California Health Insurance Plan
Health insurance for California offers different types of coverage, such as HMO plans. A health maintenance organization or HMO requires you to use specific doctors and hospitals unless you need emergency or urgent care. With an HMO plan, you'll also need to select a primary care physician who will, in effect, be the "watchdog" on your access to health care.Choosing your primary care physician is very important because that doctor must refer you to see specialists in order to have their services covered by your HMO health insurance in California. Primary care doctors are usually known as family practice, general practice or internal medicine. Does it matter which specialty you select as your primary care doctor?How Do Primary Care Physicians Differ?The identification of general practice often refers to family practice doctors from the time before family practice certification and training requirements were developed. Many osteopaths work in the general practice specialty. In general, doctors in this specialty are less likely to be board certified.The American Osteopathic Association describes osteopathic medicine is a complete health care philosophy that merges the patient's needs into the practice of medicine. Osteopaths take a whole-person approach by working with mental and physical aspects of wellness.Family practice and internal medicine specialists are certified, or are eligible for board certification and have passed specific training requirements. While family practitioners treat people of all ages, internal medicine specialists only work with adult patients. Internal medicine treats a range of chronic and general problems that are not generally serious or require specialized intervention. The family practice specialty also handles a variety of health problems that include specialized care, such as migraines, OB/GYN or sports injuries.Get Better Health Care From California Health InsuranceStart by evaluating your needs. Do you have a health condition that would be better served by a specialist? If so, contact groups dealing with that condition for recommendations. If you don't need a specialized form of care, try to make health care as convenient as possible. Look for a primary care physician close to home or work and check for the times that the doctor sees patients. When you're moving to a new location, see if your current doctor has any recommendations for doctors in the area where you'll be living. Otherwise, ask whether family and friends are happy with their doctor. Find out whether the doctors you are considering are in the network for the California insurance plans you like. In addition, call the doctor's office to confirm the doctor will accept a new patient. When everything looks good, check out the doctor's reputation.Several websites can help you evaluate physicians. HealthGrades provides information about doctors using the Centers for Medicare and Medicaid Services data. The National Committee for Quality Assurance (NCQA) can help identify providers who have been recognized by the Bridges to Excellence (BTE) program. It's a new program, so more physicians will be shown over time. To participate in BTE, doctors must act to improve the quality of the care they provide. The final step in picking your primary care physician is to call the doctor's office paying attention to how quickly the phones are answered, how responsive the receptionist is, and how far in advance you need to make an appointment. Ask which hospitals the doctor may admit patients to and what doctor sees patients in the primary care doctor's absence.If that is satisfactory, set up an appointment to see how well the staff performs, how long you have to sit in the waiting room and whether you actually like the doctor. Even though your visit goes well, find out when you can change your primary care physician just in case the situation changes. With the right primary care physician managing your care, health insurance in California can be a lot more valuable.
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