Choose a Doctor
Finding a doctor you trust is an important part of staying healthy. You're more likely to schedule regular appointments. And you'll be more comfortable asking questions about your health.
If you choose a managed care plan for your health and wellness coverage, you'll likely pay less if you use a doctor in your plan's network. In fact, you may be required to choose a primary care doctor to coordinate your health.
Determine if your doctor is in the network
You'll probably pay less when you visit doctors or other health care professionals in your plan's network. Already a UnitedHealthcare plan member? See if your doctor is in the network.
Why do you need a primary care doctor?
Choosing a primary care doctor is something most managed care plans require. But, even if your plan doesn't require it, finding one is a good idea. Why? If you see the same doctor who knows you and your medical history, that person can help coordinate your care. For example, your primary care doctor:
- Treats routine illnesses
- Performs regular check-ups and screenings
- Is your first call for health concerns
- Refers you to specialists when you require further tests or care
How to select a primary care doctor
It's important to find a primary care doctor that is right for you. Rather than randomly picking someone from your plan's network, consider these steps:
- Ask for referrals from friends and family. Then check to see if those doctors are in your plan's network.
- Search your plan's network for doctors whose locations are convenient for you and your family.
- Research the doctor's education, certification and performance history. (Websites like abms.org and ama-assn.org are great resources for this.) Also, check your health plan to see which doctors have been specially designated for quality and/or cost efficiency.
- Call the doctors on your list to find out more information about things like cancellation and payment policies, insurance claims and after-hour health concerns.
- Find out who covers for your doctor when he or she is not available.
- Schedule an appointment with your top choice to go over your medical history, discuss your health concerns and determine if it's a good fit.
Depending on your situation, you may choose different primary care providers for each member of the family. Types of doctors include:
- Family or general practitioner. These doctors care for a wide range of health concerns and may be able to treat family members of any age.
- Internist. Internists treat adults and may have additional training in specialties, such as cardiology.
- OB/GYN (obstetrics/gynecology). These practitioners specialize in women's health, including pregnancy and childbirth.
- Pediatricians. Pediatricians specialize in health care for children and adolescents.
- Geriatricians. These doctors focus on health care for older adults.
Search for UnitedHealth Premium® physicians
Not all health care is equal, and that can affect the care you receive. According to a study in The New England Journal of Medicine, "adults receive the recommended medical treatment only 55 percent of the time."1 That's why UnitedHealthcare developed the UnitedHealth Premium® designation program, which recognizes physicians that meet guidelines for providing quality and cost efficient care.
The program uses national industry standards to evaluate for quality and local market benchmarks for cost efficiency across 25 specialties, including family practice, internal medicine, pediatrics, cardiology and orthopaedics.
The designation results are displayed publicly in UnitedHealthcare's physician directories (e.g., myuhc.com) to support informed decision-making by members when making health care choices and by physicians when making referrals.
Innovative Benefit Plan Designs
In addition, employers may offer health benefit programs (e.g., reduced cost-sharing or tiered benefit plans) that provide benefit incentives for members to use UnitedHealth Premium Tier 1 physicians.
Members in health plans that offer tiered benefits may pay lower co-pays and co-insurance amounts for services provided by UnitedHealth Premium Tier 1 physicians.
UnitedHealth Premium Tier 1 physicians have received one of the following Premium designations:
- Quality and Cost Efficiency
- Cost Efficiency and Not Enough Data to Assess Quality