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Getting Ready for My Appointment

Before you get care, make sure you have everything you need. Horizon BCBSNJ gives you the information you need to get ready for an appointment.

Switching to Adult Primary Care

Switching to Adult Primary Care

Transcript

Are you over age 18 and still getting care from a pediatrician? As you get older, it’s important to have a doctor that can address your adult health care needs. Young adults between the ages of 18 and 21 should think about switching to an adult primary care doctor. Your pediatrician may be able to make a recommendation.

Changing doctors is easy. Following a few simple steps is all it takes. First, find a new in-network doctor. Use the Horizon Blue app or go to HorizonBlue.com/doctorfinder to find one. Then, have your medical records transferred to your new doctor. Finally, make sure your new doctor has your health plan information, including your member ID number.

For fast, easy and secure access to your health plan information, including a digital copy of your member ID card, download our Horizon Blue mobile app, available in the App Store and Google Play. Or, text Get App to 422-272.

Take control of your well-being. Make regular appointments with your new doctor to achieve your best health. You have access to quality health care and the tools and information you need to take care of your health.

Checklist
Being prepared for your appointment is important to getting the care you need. Use this checklist to help you get ready for your next appointment:

  • Confirm the participation status of the doctor, health care professional or hospital when making the appointment.
  • Know your medical history, including surgeries and any chronic illnesses that your family members may have.
  • Know your allergies or bad reactions to medicines, immunizations, food and seasonal irritants.
  • Write down your medicines, including prescriptions, over-the-counter, herbal and vitamins.
  • Switching to Adult Primary Care
  • Have a list of other doctors you have recently seen.
  • Make a list of tests and their results ordered by your other doctors, if applicable.
  • Have a list of your symptoms or concerns. Explain in detail, how bad and how long you have felt that way, including anything that makes it better or worse.
  • Have your member ID card and photo ID.
  • Bring your referral, prescription or prior authorization, if required.
  • Have paper and pen to take notes, and write down your questions.
  • Ask a friend or family member to go with you if you need help or support.

Questions to ask your doctor
Two-way communication between you and your doctor is key to your health. Asking questions – and answering your doctor’s questions honestly – will help you get the most from your appointment. Here is a list of some of the questions you should always ask your doctor:

  1. What tests do I need? Ask your doctor to find a participating facility.
  2. When can I expect to hear from you about the results of my tests?
  3. Will this medicine cause any side affects?
  4. Why do I need this test or medicine, and do I need a referral or prior authorization?
  5. Should I schedule a follow-up appointment?

And remember to ask questions or have the doctor repeat the information if you don’t understand something.

Print this checklist, Getting Ready for My Appointment, to prepare for your doctor's visit. Take it with you to your appointment so you remember what to tell and ask your doctor. Plus you can use it to write down important information.

Coinsurance, copayment and deductible. What’s the difference?
Depending on your Horizon BCBSNJ plan, you may have to pay a coinsurance, copayment and/or meet a deductible. Watch our videos for an explanation of each. Then check your plan documents to see which applies to you.

Do I need a referral or prior authorization?
Depending on your plan and the type of care or service you are getting, you may need a referral or prior authorization. Prior authorization means your Horizon BCBSNJ plan gives permission for you to receive a certain type of treatment, medicine or device/medical equipment based on your medical necessity and your plan’s benefits. If your plan requires a referral or prior authorization, your participating doctor will handle the paperwork for you.

To check which covered services require a referral or prior authorization, simply sign in and:

  • Select the service you want to check from the drop-down menu and click Show Coverage Details.
  • Then check the chart to see if prior authorization is required. It will say Yes or No under the Prior Authorization column heading.