Know the Rules
- Understand what services your plan does and does
not cover by reading the member handbook or talking to your employer.
- Know how to choose or change your primary care
- Understand how to schedule appointments for check-ups
and when you are sick.
- Know when you need referrals and how to get them.
- Know what you are required to do when using a hospital
or emergency room.
- Learn about any new policies affecting how the
plan works by reading member newsletters and checking the plan’s
- Know the telephone numbers and hours of your physician’s
office and of the plan’s member services department. Carry them
in your wallet or purse in case of emergency.
- Write down your health concerns to help you discuss
them with your doctor.
- Set up health files to keep track of the care and
services received by you and members of your family.
- Take good care of your health by making appointments
for check-ups and preventive care.
- Talk with your doctor about when you need regular
- Call member services if you don’t understand
information that the plan or provider sends you.
- Ask for a better explanation if you don’t
understand the answers to your questions.
Choose a Doctor Carefully
- Ask for recommendations from medical societies,
health care providers, referral services, hospitals, family members
- Get information about the doctor’s training
and experience from the plan or the doctor.
- Ask if the doctor is board certified in his or
her specialty area.
- Check whether prospective doctors have had any disciplinary actions
issued against them. For information on New Jersey physicians click