Having a Primary Care Provider (PCP) who can help ensure you get the care you need to stay healthy or treat you when you’re ill is an important part of your overall health and well-being. If you’re moving to a new city or state, switching health plans, or need to change doctors for any other reason, it can be difficult and sometimes stressful to coordinate that change on your own. Fortunately, this process is more straightforward than it might seem.
Here are a few steps you can take to find a new doctor that’s right for you and successfully make the change.
Finding a new doctor
When you need or want to change your primary care provider, keep in mind that this is the individual who will manage all of your care needs. That’s an important decision, but there are a few steps you can take to help simplify the process.
Step 1: Think about your care needs
Before you start searching for providers, make a short list of things you want to see in your new doctor. This will help you narrow down your search. Some considerations include:
- Where do you want your provider to be located (city or town)?
- If you have any medical conditions or concerns, do you want a provider who specializes in that type of care?
- Would you prefer to see a male or female provider?
- What type of PCP is right for you or your dependents – an internist (focused on adult care), a pediatrician (focused on child care), or a family practitioner?
- What kind of health insurance do you have? Does your plan require you to select a PCP (like a Health Maintenance Organization – HMO) or is it optional (like a Preferred Provider Organization - PPO)?
- Does your plan cover doctors in a specific area, or does it have tiered costs for certain doctors or hospitals?
Tip: To learn more about health insurance terms, you can visit HealthCare.gov for a glossary of common terms, or download our health insurance literacy guide.
Step 2: Research
Choosing a new doctor is an important decision, so taking some time to research your options will help you find someone who meets your care needs. There are many ways to approach this step, but here are some good ways to get started:
- Ask your doctor for a referral. If you’re parting ways with your doctor on good terms, you can always ask them if they have a recommendation. They might have a colleague in your new town, or know of someone who specializes in the type of care you’re looking for.
- Ask your friends, family, and coworkers. Talking with people you trust is a great way to learn about new doctors and get a good recommendation. They can also tell you about their experiences with different hospitals or practices.
- Do research online. Many people use online resources to find a new doctor or learn more about recommendations and referrals they’ve been given. While there are lots of tools available, here are some helpful provider search websites you can check out:
Using these methods, you can create a list of a few providers who might be good candidates for your next primary care provider.
Step 3: Important! Make sure your choices are covered by your health insurance and accepting new patients
Once you’ve picked out a few providers who meet your needs, the next step is to make sure they’re in-network for your health plan (covered by your insurance). If your health plan has a provider search tool, you can usually check which providers are covered by their network there. You can also call their customer support and ask them to check for you. They can typically be reached by calling the phone number on your member ID card.
If they are covered by your plan, the final step is to give the doctor’s office a quick call or stop by and ask the front desk staff if the doctor you’re interested in is accepting new patients. This can also be a good chance to see how friendly the office staff are and if the office is clean and welcoming. Providers often start or stop taking new patients, so it’s important to check in and make sure you have the latest information.
When you find a new doctor, here are a few steps you’ll want to take to make sure they have all your information.
Step 1: Request your medical records
For your new PCP to understand your medical history and needs, they’ll require a copy of your medical records. You have a right to paper or electronic copies of your medical records. To get a copy, ask your doctor’s office if they have a request form you can fill out or a way to access the records online. You can also ask your former provider to forward them to your new PCP on your behalf. They’ll most likely have an authorization form you can fill out that includes your new provider’s information.
Note: There’s no need to explain why you’re switching doctors if you don’t want to. Providers are used to seeing patients come and go all the time for many reasons. Of course, if you’re changing doctors because you had a bad experience or dislike something about the provider or their practice, then you are also free to give them your constructive feedback.
Once you’ve made the request, it could take between 30 to 60 days to receive or transfer your records. Be aware that if you ask to have the documents mailed to you, the office may charge you a small delivery fee.
Step 2: Inform your health insurance of the change
Members of a health plan with an HMO (or Health Maintenance Organization) plan are usually required to choose a PCP as part of their coverage. If you’re part of an HMO plan, you can change your PCP at any time by calling your plan’s customer service and letting them know the name and office location of your new PCP. You can contact customer service by calling the number provided on member ID card.
Step 3: Make an appointment
The final step in switching providers is to schedule an appointment with your new PCP. If you like the doctor and feel comfortable with having them help manage your health care, good news: your search is over!
On the other hand, if you meet with them and aren’t happy with the experience, you shouldn’t feel like you have to stay as their patient. Maybe you disliked the office or felt that the doctor didn’t fully understand or listen to you. Whatever your reason, there’s nothing wrong with looking for another provider. After all, getting regular care is one of the best things you can do for your health. If there’s anything about your new provider or their practice that might prevent you from going back as often as you need, you should look for somewhere that’s more convenient or comfortable for you.
Hopefully these steps helped make the process of finding and switching to a new primary care provider more straightforward and less stressful. If you still want to know more or need help finding a doctor in your health plan’s network, you can reach out to your insurance plan’s customer support team. They can help you search for providers and answer any questions you may have.