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QUESTIONS TO
ASK YOUR PLAN Introduction Care Physician and Specialized Treatment Centers INDEX |
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GENERAL ADVOCACY TIPS
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 medical history and care. Make sure that the provider is willing to act as your advocate and partner in obtaining any medical services that you might need. 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.
Tip: Ask for the managed care plans 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. |