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What is a primary care provider?

Everything you need to know

This article was last updated Nov. 7, 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.

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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?

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 your PCP. Some health concerns you might mention to your primary care provider are:

Common illness and injury care

Primary care doctors 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 such as heart disease, Crohn's disease, inflammatory bowel disease or asthma, regular visits to your primary care provider can help you manage your condition. Your primary doctor can help:

  • 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

Benefit plans may vary in costs when visiting your designated PCP. Please review your benefit plan material by logging in to myWellmark Secure Site.

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

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 doctor, here are some things 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 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? Here are some additional qualities to look for in a PCP:

  1. 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.
  2. Trust and open communication. Make sure there's a mutual feeling of trust and you have the ability to have open communication.
  3. Actively listens. It's important that your primary care provider listens to you, asks about your symptoms and answers your questions.
  4. Helps you understand. The provider should be able to explain a diagnosis and treatment options in a way you can understand.
  5. Involves you. A good 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 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, 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.