Why Choosing a PCP is Important

A PCP is a CareSource network health care provider who is your family doctor. They offer a range of general medical care. Their goal is to get to know you, be your trusted partner and be involved in your care for a long time.

Types of Primary Care Providers

  • Family practice – Cares for children and adults of all ages and may include obstetrics and minor surgery.
  • Nurse practitioners (NP) and physician assistants (PA) – Go through a slightly different training and certification process than doctors. They care for children and adults of all ages and can diagnose and treat your illnesses and prescribe medication.
  • Internists – Care for adults and elderly patients and have extra training in the body’s internal organ systems.
  • Pediatricians – Care for infants, children, and adolescents up to age 18.
  • OB/GYN (Obstetricians/gynecologists) – Serve women, particularly those of childbearing age. Obstetricians (OB) focus on pregnancy and its health issues. Gynecologists (GYN) are focused on women’s reproductive health in general.
  • Geriatricians – Care for older adults with complex medical needs related to aging.

What Does a PCP Do?

Your PCP can take care of most of your health care needs. If you have a more serious issue than your PCP can manage, they can refer you to a specialist. However, you can also see an in-network specialist without a referral.

Types of PCP Visits

  1. New Patient Visit*
    Your first appointment with a new provider is done to establish a relationship with the PCP and the office. During this visit you will talk about your medical history and concerns you may have. You may be given an exam and be sent for preventive or diagnostic services, such as lab work.
  2. Annual Wellness Exam*
    This yearly visit is to have a physical and complete your annual preventive screenings. It may include a physical exam and:
    • Reviewing your vitals (blood pressure, heart rate, height and weight) and medicines you are taking. This includes over the counter drugs, vitamins and supplements.
    • Order and review blood tests and other labs.
    • Recommending actions to prevent future health issues. This includes any shots you may need (flu, COVID, tetanus, measles, etc.).
    • Talk about diet, nutrition and physical activity along with tobacco alcohol or other substance use, if needed.
    • Discuss preventive screenings for your age, risk factors and family history.
    • Talk over any new health concerns you may have.

    Tip: The annual wellness visit is free to you when billed correctly. Keep in mind that cost-sharing (deductible, copay or coinsurance) may apply to tests or other services that your PCP orders during the annual visit.

  3. Office Visit (for illness, injury or follow up)
    An office visit may be needed for many reasons. You might be ill or have a medical issue that was found during your new patient or annual exam. Or you could be taking a medicine that needs monitoring.

*These visits may have some exclusions. For a complete description of covered benefits, please see your Certificate of Coverage.

Finding the Right PCP

Forming a relationship with your PCP can help you get and stay healthy. You should feel respected, listened to, have options and understand your care.

Things to consider when choosing a PCP

  • Recommendations from people you trust.
  • Do you want your PCP to have a special certificate or training?
  • Can they treat your medical condition?
  • Do you want them to be affiliated with a certain hospital?
  • Who will treat you if your PCP isn’t available? Are there other doctors in the practice?
  • Do the times work with your life? Do they have evening or weekend hours?
  • Are they accepting new patients?

Tip: Our Find A Doctor tool can be used to search for primary care doctors, specialists, hospitals and more. Once you narrow down your search, call the provider’s office.

  • Make sure the PCP is still in-network for your CareSource plan.
  • Ask if they are taking new patients.
  • If the answers are yes, you can set up your first appointment!

Prepare for Your Appointment

Keep a notebook for your medical appointments to write down:

  • Questions and concerns you want to discuss.
  • Your medical history:
    • Known allergies and medical issues.
    • Past surgeries and their dates.
    • Prescription drugs and their doses
    • Over-the-counter medicines, vitamins or herbal remedies you take.
    • Preventive tests and vaccines received. Include the most recent dates for each.
    • Doctors you have seen for other types of care.
  • Family medical history.

Take to the appointment your:

  • Member ID card.
  • Credit or debit card to pay any out-of-pocket cost required for your visit.
  • Notebook with your questions, concerns and medical history.

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