Accessing Primary Care
Seeing your primary care doctor should always be your first choice in non-emergency situations. Your doctor knows your health history and is your partner in keeping you healthy. Having a medical home with your doctor means coordination of care, routine screenings, and the ability to get care more quickly when you are sick.
Don’t have a primary care doctor? It’s easy! Just select a doctor in your network and schedule your annual physical to establish care. Visit the [link] Healthcare Insurance page to find the provider search tool for your ACA Marketplace insurance plan. If you need to see a specialist for a specific condition or concern, see your primary doctor for a referral.
For more helpful tips, check out our guide on How to Get the Most from your Insurance Plan.
When To Visit the Emergency Room
In the case of an emergency, call 911 or go to the nearest hospital. You should only visit the ER in the case of an emergency, for traumatic or life-threatening illnesses or injuries. This includes, but is not limited to:
Chest pain
Head injuries
Heavy bleeding/deep cuts
Shortness of breath
Seizures
Broken bones
Although open 24/7, the emergency room should not be used for routine care or minor illnesses or injuries as it is the most expensive option for care.
For information on accessing care while you’re out of town, check out our On the Road handout.
Accessing Specialty Care
When you need specialized care beyond what your primary care doctor can provide, you may need to see a specialist. Dermatologists, ENTs, Cardiologists, and Neurologists are just a few examples of specialists.
Some insurance plans require a referral from your primary care doctor to see a specialist. Be sure to check and make sure any doctor you see is in-network with your insurance plan – this is your responsibility as the insurance policy holder. If you see a doctor that is not in-network with your insurance plan, you may be responsible for the full cost of the visit.