There are many reasons why you may need a new primary care provider (PCP). Maybe you're relocating or you got a new job that offers different insurance. You could also have a personal preference for switching to a better fit for your healthcare needs. Making this change can be challenging and sometimes time-consuming. But with the right approach, you can make the process smoother and ensure you continue receiving the quality care you deserve. Here are some practical tips to help you when switching to a new doctor.
Ask yourself the right questions
Before you begin searching for healthcare providers, take a moment to create a list of key qualities you’d like in your new doctor. Some questions to ask yourself:
- Where is your preferred city or town you’d like to see your provider?
- If you have any specific health concerns, would you prefer a provider specializing in that area?
- Do you have a gender preference?
- What type of PCP is best for you or your dependents? This could include adult care, pediatrics, or a family practitioner.
- Does your insurance plan require you to choose a PCP (Health Maintenance Organization – HMO), or is it optional (Preferred Provider Organization – PPO)?
- Does your insurance plan cover doctors in specific areas, or does it have different cost tiers for specific providers or hospitals?
- Do you have a language preference or cultural competency?
Start your search
Choosing a new doctor is an important decision, so taking some time to research your options will help you find someone who meets your care needs. There are many ways to approach this step, but here are some good ways to get started:
- Ask your doctor for a referral. If you’re parting ways with your doctor on good terms, you can always ask them if they have a recommendation. They might have a colleague in your new town or know of someone who specializes in the type of care you’re looking for.
- Ask your friends, family, and coworkers for recommendations. Talking with people you trust is a great way to learn about new doctors and get a good recommendation. They can also tell you about their experiences with different hospitals or practices.
- Look online. Many people use online resources to find a new doctor or learn more about the recommendations and referrals they’ve been given. You can read reviews online, but make sure to check multiple sources and remember that one negative review may not represent the overall experience
Using these methods, you can create a list of potential candidates.
Check your coverage
Make sure your choices are covered by your health insurance. Then, confirm that they are accepting new patients. Once you've selected a few providers that meet your needs, the next step is to confirm they are in-network for your health plan. Use your plan’s provider search tool to check coverage. Alternatively, you can call customer support using the number on your member ID card to verify. If the provider is covered by your plan, the next step is to reach out to the doctor’s office. Since providers may change their patient intake status, it's important to confirm the most current information.
I’ve decided on a new PCP, now what?
When you find a new PCP, follow these steps to ensure they have all your information.
Step 1: Request your medical records
Your new PCP will need a copy of your medical records. To get a copy, ask your doctor’s office if they have a request form you can fill out or a way to access the records online. You can also ask your former provider to forward them to your new PCP on your behalf. Once you’ve made the request, it could take between 30 to 60 days to receive or transfer your records. Be aware that the office may charge you a small delivery fee if you ask to have the documents mailed to you.
Step 2: Inform your health insurance of the change
Call your plan’s customer service and let them know the name and office location of your new PCP. You can contact customer service by calling the number provided on your member ID card.
Step 3: Make an appointment
The final step in switching providers is to schedule an appointment with your new PCP. While a PCP may be accepting new patients, you may not be able to secure an appointment right away. In this case, you can ask to be placed on a waiting list.
If you have immediate health concerns, you can always seek urgent care. At times, it may be quicker to get a virtual visit, too.
Step 4: Follow up
After your first visit to the new doctor, follow up on any pending tests, prescriptions, or recommendations. This helps the new provider to be more thorough in their care and so you don’t lose track of any critical healthcare matters during the transition.
Additionally, give yourself some time to assess your experience. If you feel like the relationship is improving and the care is satisfactory, continue building trust. If not, don’t hesitate to seek another doctor. Remember, your health is the most important factor, and you deserve a provider who makes you feel heard and cared for.
By following these tips—doing your research, ensuring insurance compatibility, properly transferring medical records, and maintaining clear communication—you can make the transition smoother and feel confident in your choice. Ultimately, finding a doctor who aligns with your healthcare needs and makes you feel comfortable is a critical step in maintaining your overall well-being.
To learn more about health insurance terms, you can visit HealthCare.gov for a glossary of common terms, or download our health insurance literacy guide.
If you’re a member of Mass General Brigham Health Plan, make sure you sign up for our member portal.
