Having a primary care provider, usually called a PCP, is kind of a thing in the healthcare world. Even if all you ever do is go to the local walk-in or urgent care when you feel sick, someone almost always asks you about your PCP. You may think you can’t afford one, but most health plans include benefits that help lower your out-of-pocket costs if you have a PCP.

In fact, most health plans, including those offered by Community Health Options, encourage you to choose a PCP, like a doctor, nurse practitioner or physician’s assistant.  Here’s what a PCP can do for you:

• Give you access to preventive care and a regular checkup to help you stay healthy.
• Offer personal health advice from someone who knows you.
• Help you manage chronic conditions.
• Find possible health problems early, while you can do something about them.
• Refer you to a specialist to get the best possible care when you need it. Keep in mind that many specialists will want a referral before they see you.

No PCP? What’s the harm?

It might not seem important, but you could be putting your health at risk if you don’t have a PCP. Risks include:

• Paying more for care—and waiting longer to see a doctor—by relying on walk-ins or emergency rooms. You’ll save time and money by calling your PCP to get guidance when you don’t feel good and paying the flat copay included in many health plans.
• Learning you’re sick long after you could have taken simple steps to prevent an illness or condition. High blood pressure or high cholesterol, for instance, can creep up on you without symptoms and cause issues if left unchecked.
• Suffering with declining health through poorly managed chronic conditions.

How do I get a PCP?

• Know your health plan benefits. Make sure you choose a PCP covered by your health insurance plan and is considered in-network. You can learn about the Community Health Options’ network here. (Visit your Member portal for your health plan’s specific network.)
• Ask friends, neighbors, colleagues about their PCPs to find someone who might fit your needs and personality.
• Consider the location and whether the doctor is close enough for convenient appointments.
• Ensure the provider can meet your health needs if you or a family member has special needs.

Community Health Options Members without a PCP can choose one—including virtual primary care through Firefly Health for Members 18 and over—in their Member portal. Members can also find details about specific plan benefits, including coverage for preventive and non-preventive services.

Have a question about plans and what’s covered, or need help finding a PCP? Call Member Services at (855) 624-6463 from 8 a.m. to 6 p.m. Monday through Friday.

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