Tip: Ask for a current listing of the primary care providers, specialists and health care facilities that are part of the health plan’s network of providers.

Tip: Find out if you can continue to obtain care from your current provider. If so, for how long? Some health plans will allow certain individuals to continue to obtain care from their health care provider even if the provider is not part of the health plan’s network. Generally, continuation provisions are limited to individuals with special health conditions, and only last for a limited amount of time.

Tip: If you have a special health care condition, you may want to check whether the HMO will let you use your specialist to coordinate your care. For example, you may want to have your specialist serve as your PCP, if you have received a transplant, have sickle cell anemia, HIV or kidney failure (End Stage Renal Disease). It is important to receive regular check-ups and to obtain preventive clinical screenings (such as mammograms or pap smears) even if a specialist is coordinating your care.

Tip: Even though a physician or group practice may be listed in a provider directory it does not necessarily mean that the practice accepts new patients. When a physician’s practice is full, he or she may stop taking new patients. It is important to ask the health plan or call the physician’s office to see if new patients are being accepted.