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You and Your California medical insurance HMO Doctor

Your primary care doctor gives you your basic care and oversees your treatments. In most HMOs, you must choose a primary care doctor. You can change doctors if you do not like the doctor you have.

Your Rights

  • Your doctor must help you get the services you need and understand your care.
  • Your doctor must tell you all of your treatment choices, even if they are not all covered by your plan.
  • Your doctor must make sure that you give informed consent when you have a treatment.
  • You can change doctors if you want. It can take up to a month to get a new doctor.
  • If your doctor or medical group leaves your medical plan, you must be told so you can get another doctor.

Choosing a Doctor

  • Your primary care doctor can be a family doctor, an internist, a pediatrician (children's doctor), a gynecologist (women's doctor), or a nurse practitioner who works with a doctor.
  • Your primary care doctor's office should be easy for you to get to. You can usually ask for a doctor within 15 miles or 30 minutes of your home or work.
  • Ask your medical plan for a list of primary care doctors. You may have to call more than one doctor before you find a doctor who is taking new patients.
  • Ask friends and co-workers for the names of doctors they like.

Make the Most of Your Visit

  • Bring a list of your questions and concerns.
  • Bring a list of all your medicines (including over-the-counter medicine and supplements) and how much (the dose) you take of each one.
  • Repeat what your doctor tells you in your own words, to make sure you understand.
  • Take notes.
  • Ask how to reach your doctor between visits.
  • Bring someone with you for support.

Medical Groups

A medical group is a group of doctors who have a business together and have a contract with a medical plan to give services to the plan members. Your primary care doctor and most of the specialists you see will usually be a part of your medical group.

You may receive your care through a medical group, but it is your medical plan that is responsible for covering your medical care. This means your plan must make sure you get the same level of medical care no matter who your doctor is or what happens to his or her medical group

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