This article was last updated on March 10, 2023.
You know it’s important to have a primary care provider (PCP), also known as a primary care physician, primary doctor or personal doctor. After all, a trusted relationship with your doctor could mean better health overall. Yet, many people don't have a primary care provider. In fact, only 68 percent of millennials have a primary care provider, according to a Blue Cross® Blue Shield® Health of America Report® External Site.
Need a new primary care provider in your network?
Log in to myWellmark®, a secure portal for Wellmark Blue Cross and Blue Shield members. myWellmark is there to help you find an in-network provider or primary care physician who is conveniently located near you. Don’t have an account? Get registered quickly and easily today!
What is a primary care provider?
A primary care provider or primary care physician practices general health care, addressing a wide variety of health concerns and preventive care. If you have a Wellmark Blue Cross and Blue Shield health insurance plan, you may have to notify Wellmark of your PCP choice, depending on your plan's network.
The relationship between you and your PCP should be one that's long term. This isn't the physician you go to once and never see them again. Think of your PCP as your medical "home" External Site. They should be someone you feel comfortable with, who can listen to you and understand your needs and then direct your care appropriately.
What do PCPs do?
PCPs are typically your go-to for an annual preventive exam, routine screenings and non-emergency illnesses like earaches and sore throats. Some health concerns you might discuss with your primary care provider are:
- High blood pressure
- Other risk factors for heart disease
- High cholesterol
- Your risk for common cancers, like breast, cervical, prostate or colorectal cancer
Different types of primary care providers
There are many different kinds of providers and primary care doctors who may be classified as PCPs. You may hear them referred to as:
- Family doctors, who provide care to all ages
- Internists, who focus on internal medicine, which is the medical practice that's focused on adults
- Pediatricians, whose training is geared toward supporting the health of infants, children, adolescents and young adults
- Geriatricians, who are uniquely trained and qualified to treat older adults over the age of 65
- Nurse practitioners (NP) and physician assistants (PA), who have received advanced degrees and special training External Link to provide many of the same services as doctors
Considerations to help you choose the right primary care provider for you
If you haven't chosen a PCP because you're new to the area or just switched health plans, for example, here are some basics to consider.
- 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 primary doctor, 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 work for your schedule. You may also 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 Opens New Window. If at any time you need more specialized care, your dedicated primary care provider or doctor may have to submit a referral, depending on your health plan network. Oftentimes with a referral, you can avoid additional or unexpected costs.
Qualities to look for in a new PCP
A positive relationship with your primary care provider or primary care physician 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?
[VIDEO] How to choose and use a primary care provider
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 or primary care doctor keeps you involved in your health and values your opinion on treatment options.
What to expect during a visit with your primary care provider
If you're visiting a new PCP for the first time, they'll likely take time during your appointment to establish care. They will likely discuss your current health status, your health history and any questions or concerns you might 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, log in or register for myWellmark Secure Site to make sure the doctor and facility you are considering is in your health plan network. With myWellmark you can also:
- Check quality scores and reviews of health care providers with locations closest to you.
- Know what your visits will cost before you go.
- And, much more.
myWellmark is your once-stop 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.
