What is a primary care provider?
It’s important to have a primary care provider (PCP). After all, a trusted relationship with your doctor could mean better health overall. Yet, 20 percent of Americans don’t have a primary care provider and that percentage increases for younger generations, according to a Yahoo News/YouGov poll.
What is a primary care provider?
A primary care provider practices general health care, meaning they address a wide variety of health concerns and preventive care. If you have a Wellmark health insurance plan, you may be required to notify Wellmark of your PCP choice, depending on your plan.
The relationship between you and your PCP should be one that's long term. This isn't the provider you go to once and never see them again. Think of your PCP as your medical "home." They should be someone you feel comfortable with, who listens to you, understands your needs and directs your care appropriately.
Find an in-network primary care provider
With myWellmark®, finding the right care is simple. You can easily search for a trusted, in-network primary care provider near you so you feel confident knowing your health is in good hands.
What do primary care providers do?
Wellness and preventive screenings
PCPs are your go-to source for your annual preventive exam and can run routine screenings as part of your preventive care plan. You can also bring up any health concerns to them. Some health concerns you might mention to your PCP are:
- High blood pressure.
- High cholesterol.
- Other risk factors for heart disease.
- Your risk for common cancers, like breast, cervical, prostate or colorectal cancer.
Common illness and injury care
Primary care providers can help with many acute illnesses and injuries. Your PCP can:
- Diagnose and create a treatment plan for non-emergency illnesses, such as ear aches, insect bites, cold symptoms and more.
- Perform lab tests to diagnose your condition, if needed.
- Assess minor injuries, including sprains or strains, minor burns, cuts and scrapes and more.
- Provide an injury management plan, including how to reduce the risk of re-injury.
- Prescribe appropriate medications for treatment or management.
Chronic condition management
If you are living with a chronic disease like heart disease, Crohn's disease, inflammatory bowel disease or asthma, regular visits to your primary care provider can help you manage your condition. Your PCP can:
- Regularly assess the effectiveness of your treatment plan and make changes as needed.
- Prescribe medications and work with you to adjust your dose.
- Coordinate your care with specialists.
- Recommend diet, exercise and self-care changes that improve your quality of life.
Benefits may vary in cost when visiting your designated PCP. Please review your plan’s coverage information in myWellmark.
Different types of primary care providers
There are many different provider types that may be classified as PCPs:
- Family doctors provide care to all ages.
- Internists focus on internal medicine, which is also known as adult medicine.
- Pediatricians support the health of infants, children, adolescents and young adults.
- Geriatricians are uniquely trained and qualified to treat older adults.
- Nurse practitioners (NPs) and physician assistants/physician associates (PAs) have received advanced degrees and special training to provide many of the same services as doctors.
Considerations to help you choose the right primary care provider
If you recently moved to a new area or switched health plans, you may not have a PCP yet. When you're picking a new primary care provider, here are some things to keep in mind.
In-network vs. out-of-network
When choosing a primary care provider, it's important to make sure they're part of your plan’s network. If you choose an out-of-network health care provider or PCP, you may be responsible for the full cost of care.
Details about the office where the primary care provider practices
If you're sick or have an issue that requires a visit with your primary care provider, you'll want to make sure their office is conveniently located to you and has hours of operation that fit your schedule. You may also want to ask the facility about language assistance and potential virtual visit options, if needed.
Provider specialties or board certification
Primary care providers can often have specialties, like pediatrics or family medicine. A provider's specialties, certifications, designations and achievements are typically listed on the facility's website. For in-network providers with Wellmark, you can see their specialty when you find a doctor or facility. If at any time you need more specialized care, your dedicated primary care provider may have to refer you to a specialist, depending on your health plan network. Often with a referral, you can avoid additional or unexpected costs.
Qualities to look for in a new primary care provider
A positive relationship with your PCP is associated with greater satisfaction, better overall health and lower hospital and emergency room use.
But, how do you choose the right provider for you? Here are some additional qualities to look for in a PCP:
- Interest in your whole being. Find someone who shows empathy and takes interest in your whole being, not just your symptoms. That means physical, mental and emotional well-being.
- Trust and open communication. Make sure there's a mutual feeling of trust and you have the ability to have open communication.
- Actively listens. It's important that your primary care provider listens to you, asks about your symptoms and answers your questions.
- Helps you understand. The provider should be able to explain a diagnosis and treatment options in a way you can understand.
- Involves you. A good primary care provider keeps you involved in your health and values your opinion on treatment options.
What to expect during your first visit with a primary care provider
If you're visiting a new PCP, they'll likely take time during your appointment to establish care. They may discuss your current health status, your health history and any questions or concerns you have. You may also discuss with them the prescriptions or supplements you take regularly.
Find a primary care provider with myWellmark
If you're a Wellmark member, myWellmark makes it easy to see which providers or facilities are in-network. With myWellmark you can also:
- Check quality reports and reviews of health care providers.
- Know what your visits may cost before you go.
- And, much more.
myWellmark is your source for personalized health care information. If you haven’t registered yet, it’s easy. All you need is your Wellmark ID card and a personal email address. Register for myWellmark today!