Getting involved in your health care can help you get the most from your health coverage.

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.

Stay Informed

• 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.

Keep Records

• 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 Charge

• 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.

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