Tip: It is critical that your primary care provider understands your needs and is willing to help you navigate the managed care system. You may need to change providers if you change health plans. If possible, you should interview potential primary care providers before selecting a new provider. Make an appointment to introduce yourself and tell the provider about your health condition, medical history and care. Make sure that the provider is willing to act as your advocate and partner in developing a treatment plan. If your condition is very rare, you may need to educate your physician about your condition and available treatment options. By establishing a positive relationship with your primary care provider early on, you are more likely to avoid later problems.

Tip: The NC Institute of Medicine and the NC Department of Insurance have information that you can use in selecting a health plan. For example, the NC Institute of Medicine has information comparing the benefits covered and excluded under the most commonly purchased HMO plan. This information can be accessed through http://www.nciom.org/hmoconguide/backh.html. The NC Department of Insurance has two guides comparing health plans: "Managed Care Plan Handbook: A Comparison Guide for North Carolina Consumers" and "HMO Performance Report." These guides can be ordered from the NC Department of Insurance by calling: 1-800-622-7777 or 1-800-546-5664.

These materials are generic in nature, and do not generally focus on the care for people with specific health conditions. Talking to other people with similar health conditions who are enrolled in a specific health plan may give you an idea of how your health care needs will be treated by that plan.

Tip: Ask for the managed care plan’s Evidence of Coverage (EOC) or policy contract before you select a plan. This document contains detailed information about the covered benefits and exclusions for a particular plan. Sometimes you will only receive a summary of the benefits unless you ask for the more detailed EOC.