Access: the Doorway to Good Care
Let’s say you have health insurance and you’ve found a highly recommended doctor. You verified she’s in-network and accepting new patients. You’re all set. Thumbs up!
Then you get sick, try to make an appointment, and can’t get an appointment as soon as you need to. What? Thumbs down!
If you’ve ever had this frustrating experience, you know good healthcare depends on good access to care. Access to care includes several factors, such as: How quickly can you get in to see your doctor? How long is the wait time for the appointment?
Getting Care from Your Primary Care Provider
How soon you can get an appointment can vary depending on whether or not you’re an established patient. Being an established patient means you’ve already received care or had a new patient visit with a provider. If you don’t already have a primary care provider, we recommend you find a doctor and schedule a new patient appointment sooner rather than later. That way, if you get sick or need to get in to see your doctor quickly, you’re more likely to get an appointment sooner than you would as a new patient.
What kind of care you need also plays into how soon you can get an appointment. For example, if you need routine care, such as a follow-up visit or a prescription refill, you may be able to get an appointment more quickly than you would for a preventive care service, like an annual physical.
When it comes to preventive care services, we also recommend scheduling your appointments earlier in the year. That way, if you do need to accommodate longer wait times to get an appointment, you have plenty of time to be seen before the end of the year. This will help you get the most value from your health insurance benefits.
If Your Wait Is Longer than Expected
So what can you do when your doctor isn’t available as soon as you’d like? Even five days can feel like a long time when you’re feeling miserable—but a trip to an emergency room can end up costing you a lot more out of pocket. Here are a few ideas.
- Grab a canceled appointment – Call your doctor’s office around 10:00 a.m. to see if they’ve had any cancellations that morning. They could have an unexpected opening in the afternoon. If not, ask to be put on the cancellation list. Most offices are happy to do this.
- Talk to a nurse – Many health plans offer hotlines members can call anytime to speak to a registered nurse. RNs are qualified to answer a variety of health questions and can help you determine the best course of action. Most PacificSource members with medical coverage can call our 24-Hour NurseLine toll-free at (855) 834-6150.
- Access virtual care, also known as telemedicine, if it’s offered by your health plan – PacificSource Health Plans and other health insurance companies partner with Teladoc® on some plans to offer members this service. Teladoc is a national network of U.S. board-certified physicians and pediatricians that you can see on-demand, 24/7, via phone or online video consultations, from wherever you are. Some limitations apply. Visit PacificSource.com/teladoc for more information. To find out if your health plan includes telemedicine services, contact your health insurance company.
Now that you’re armed with tips for getting the care you need and for coping with access delays, we hope you have that “thumbs up” feeling again. Please tell us what you think in the comments below.