My Coverage Explained

Getting to Know Your Doctor


Here are 11 common questions to ask your doctor or other health care provider:

  1. Will your services and any treatment or surgery be covered by my health insurance? Are you in my health insurance plan’s network?
  2. How accurate and safe are the tests that you want to run?
  3. Can you tell me about your training and experience? What about your staff?
  4. How did you decide my diagnosis? Are there other possible causes for my symptoms?
  5. Do I need to change my day-to-day habits?
  6. Is there more than one treatment option for what I have?
  7. Is it likely that the treatment will work?
  8. Can you tell me about how this treatment was proven to be safe? How can I be sure the treatment is working?
  9. If surgery is recommended, what are the risks?
  10. What are the side effects of the drug you want me to take? Are there generic drugs available that would be just as effective as name-brand?
  11. How may I reach you or your staff if I have follow-up questions?

Being able to talk with your doctor can help you stay healthy.
Talking openly with your doctor helps with:

  • Diagnosis: Figuring out the problem is the first step to treating it. There are many different health issues which cause the same symptoms.  Tell your doctor how you feel and if you have felt this way before. Also, talk about where you have been and what you have been doing recently. Some places and environments can affect your health in ways you may not know about.
  • Ask a doctorTesting: Your doctor may need to run tests. You should ask the doctor or staff about what tests they recommend. Some tests are simple. Other tests may require some preparation. You may also need someone to be with you. Ask about any risks of the test. Also ask when you will get the results and how they will be explained to you.
  • Treatment: Sometimes you may have choices. You may need to change what you eat or how active you are. You may need to take a new medicine or consider surgery. Ask your doctor about any risks. Ask yourself, is there anything stopping you from following your doctor’s instructions? If so, be sure to tell your doctor.
  • Medicines: Sometimes your doctor needs to prescribe medicine. Tell your doctor if you have ever had any bad reactions to certain medicines. If so, you may be allergic to them. Also, ask the doctor if any new medicine may have side effects. Be sure to tell your doctor if you are currently taking any medicines, vitamins or supplements before you receive a new prescription. Medicines do not always work well together.
  • Cost: Of course, remember to ask your doctor if he or she is in your health insurance plan’s network. If you are covered by a PPO plan, your costs will be higher if the provider is not in your plan’s network. If you are covered by an HMO plan, then your primary care physician (PCP) directs all of your health care. This also means that before seeing any specialist, you will need to see your PCP and first get a referral. Be sure to always ask for an in-network specialist. You can also call your health plan if you have questions that your PCP couldn’t answer. Use the phone number on the back of your member ID card to reach Customer Service.

Get ready before you see your doctor.
Do you speak the same language as your doctor? Doctor listings show what languages the doctor speaks in our online Provider Finder® tool.

Making lists and notes before your visit can help you remember everything you need to say. Some symptoms or questions may be hard to talk about or bring up. Write down some keywords you can use to get started. Notes can help you to make the best use of your time. Here is what visit notes should include:

  • A list of symptoms: When did your health concern start? Where does it hurt? How badly does it hurt? Does it get better or worse with activity? Does rest help? Does what you eat make a difference?
  • Your list of questions: Some questions you know ahead of time. Some questions pop up as you talk with your doctor. Notes help make room for both.
  • Your health history: This could include past illnesses, injuries, diseases, allergies or anything that has affected your health. Be sure to mention your family’s health history.

You should also bring:

  • Current medication: A list of drugs is a great start, but if you can, you should bring in actual prescription drug and/or over-the-counter supplement bottles. The labels on your medicines can give the doctor more detail.
  • Records: Bring your records from previous tests or procedures, including X-rays. Written test results and surgery reports can have helpful notes for your doctor. You can always ask for a copy of your files from the previous doctors you have seen.
  • Another person: Bring a trusted friend or relative with you if you're worried.

Ask questions and repeat the doctor’s answers. Your doctor will know you care about your health. Ask more questions if you need to during and after your appointment, even if it’s questioning something that doesn’t appear to be correct on your Explanation of Benefits.

Most recent update: 9/28/2017

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