Primary and Specialty Care

Primary Care Overview

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. You can find your insurance's provider search tool on the Using Your Insurance page. If you need to see a specialist for a specific condition or concern, see your primary doctor for a referral. Check out the Specialty Care page for more information. 

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.

Specialty Care

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 will be responsible for the full cost of the visit, in most cases.

Mental Health and Substance Use Recovery

Millions of people in the U.S. are affected by mental illness and substance use each year – you are not alone. As with other serious illnesses, mental illness is not your fault or that of the people around you, but widespread misunderstandings about mental illness remain. Many people don't seek treatment or remain unaware that their symptoms could be connected to a mental health condition. But mental health is just as important as physical health, and anyone can experience mental illness, regardless of race, ethnicity, age, sexual orientation or gender identity.

HAAM members have access to counseling, psychiatry, mental health inpatient services, and substance use treatment through their Marketplace insurance plans and community sliding fee scale clinics. The best place to start is by talking with your Primary Care Doctor about your symptoms. If necessary, your doctor can make a referral to the appropriate Mental Health Specialist for further evaluation and treatment. Be aware that your insurance might require a referral to see a specialist or need a pre-authorization from the provider before certain visits. If you have questions about navigating these services, you can reach the Member Services team at 512-541-4226 and press option 3.

SIMS Foundation - HAAM members also have access to mental health and substance use recovery services through the SIMS foundation. SIMS is also able to support the immediate family of Austin-area musicians, as well as music industry professionals.

To get started, call the SIMS confidential client line at 512-494-1007 or visit their website.

If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.