Why do I need a primary care provider?
Some health plans require you to choose a PCP. While other plans do not require you to choose a PCP, it may be a good idea to have one. Watch a video to learn more about the benefits of having a PCP.
A PCP can help guide you through your care. As they get to know you, they can learn more about your health over time. They may watch for small changes in your health to help spot warning signs of potential health concerns earlier. Start your search by finding a provider in your network.
Can I see a specialist without a referral?
Whether you need a referral often depends on your health plan and the specialist’s office.
With certain plans, you can make appointments with a specialist on your own. Other plans may need a referral from a PCP before the visit is covered. If you’re not sure, check your plan details or call the specialist’s office before you schedule.1
Consider virtual visits
Virtual visits, also known as telehealth, are one way you can connect with a health care provider using your computer, tablet or smartphone. Virtual visits may be covered by your health plan just like an office visit with a doctor.
Depending on your benefits, you may be able to schedule a virtual visit with a local provider. You may also be able to book virtual visits for primary care, therapy, specialty care or urgent care when your provider is not available.
Types of primary care providers
Providers can receive board certification in a range of specialties. Board certification is a sign of going above and beyond state licensing requirements and receiving supervised in-practice training. To find a board-certified family doctor, visit the American Board of Family Medicine online directory. To check if a physician you may be considering is board-certified, visit the American Board of Medical Specialties’ Certification Matters database.
Each member of the family may require a different type of PCP, such as:2
| Provider | Services |
|---|---|
| Family medicine doctor | Provides preventive and whole-person care for patients of all ages |
| OB/GYN (obstetrics and gynecology) | Specializes in women’s health to help with family planning, pregnancy and menopause and provide preventive screenings like mammograms and Pap smears |
| Pediatrician | Works in collaboration with parents and other health care providers to serve patients from newborn to 18 years old |
| Internal medicine/internist | Treats adult patients aged 18+ and may specialize in cardiology, endocrinology, gastroenterology, infectious disease, hematology, oncology, pulmonary disease, rheumatology and immunology |
| Geriatrician | Focuses on common medical conditions and concerns related to aging in older adults aged 60+ conditions that affect the organs of the body |
Looking for other types of providers?
Choosing a PCP is an important step in helping manage your overall health and well-being. Addressing concerns related to mental health, eye health and oral health are also part of supporting a healthy body and mind. Whatever your reason for finding a new provider, the start of your search may feel intimidating. Below, you can find some tips to help simplify the process.
Mental/behavioral health providers
There are many different types of providers who can help support your mental health. Some people benefit from seeing a combination of mental health professionals. This may include social workers, counselors/therapists, psychiatrists or psychologists.
Vision care providers
It's important to visit the eye doctor, even if you don’t wear glasses or contacts, to help support your eye health. The UnitedHealthcare Vision network includes 2 types of eye care providers: optometrists and ophthalmologists.
Dentists
Routine dental care is important to your overall health. Your plan may include coverage for preventive and comprehensive dental services like cleanings, fluoride, fillings, crowns, root canals, extractions and dentures.
How to choose your doctor
It helps to do some research before choosing a doctor. Here are some questions to ask yourself to help you choose a doctor:
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Have my friends or family, medical specialists or other health professionals recommended them?
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Why do people like this particular doctor?
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Does gender matter? Does age?
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Do I want a clinic close to home or close to work?
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How far am I willing to drive?
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Is the tone of their website more formal or more casual?
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How are their consumer reviews? (Although, reviews are just opinions. Unless a doctor receives many reviews, one or 2 may not paint the whole picture.)
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Do they have a social media presence?
Questions to consider when choosing a PCP
When reviewing potential candidates for a new PCP, carefully review all your options. Check to see if the PCP is in your plan’s network. Consider the following questions before making your final selection.
Everyone has different health needs, and these needs change as we get older. Ask your doctor about their special areas of care. For example, if you have a chronic condition like diabetes, you may want to look for a provider who specializes in diabetes care.
Maybe you’re a member of the LGBTQ+ community looking to start a family. Or, you want to explore or continue gender-affirming care. Having an experienced provider who understands the type of care you need can help you feel safe, supported and seen.
To find LGBTQ+ friendly providers, sign in to your member account. Search or browse using the Care categories. Select View all. Then filter by Area of expertise and select LGBTQ Supportive. You can also learn about LGBTQ+ resources available to UnitedHealthcare members.
Once you narrow down possible options, call the clinic and ask questions. First impressions matter. Pay attention to the office staff. Are they helpful and friendly? Some common questions include:3, 4
- Is the doctor taking new patients?
- How long does it take to get an appointment?
- If your doctor isn’t available, who will you see?
- Which hospital are they affiliated with?
- Does the doctor have special training?
- Do they offer any weekend or evening appointments?
- Can you message the doctor outside of clinic hours?
- Can you get lab work or X-rays done in the office?
- Is the doctor board-certified?
It may be hard to tell if a provider is a good fit until you meet them. You’ll be sharing personal health information — make sure you feel comfortable. After meeting, ask yourself:
- Did they give you a chance to ask questions?
- Did they let you openly voice your concerns?
- Did you feel rushed?
- Did you feel safe and respected?
- Did it feel like it could become a true partnership?
Your PCP may save you money — with fewer emergency room visits, for example — and can connect you with specialists. They can advocate on your behalf. Once you establish a relationship, they’re also more likely to recommend preventive screenings, checkups and tests.5