Know the Rules
- Understand what services your health benefits plan does and does not cover by reading the evidence of coverage or talking to your employer.
- Know how to choose or change your primary care physician.
- Understand how to schedule appointments for check-ups and when you are sick.
- Know when you need referrals or preauthorization for a procedure 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 HMO and your health benefits plan works by reading member newsletters and checking the HMO’s web site.
- Know the telephone numbers and hours of your physician’s office and of the HMO’s member services department. Carry them in your wallet or purse in case of emergency.
- Write down your health concerns and keep a list to discuss them with your doctor.
- Create 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 health screenings.
- Call member services if you don’t understand information that the HMO 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 and friends.
- Get information about the doctor’s training and experience from the HMO 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.
Click here for more information on New Jersey physicians