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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Primary Care Provider?

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Question: Why am I being asked to select a Primary Care Physician for a PPO plan? I thought the whole idea of a PPO is to be able to see any provider in the network.

Answer: Covered California believes that being matched with a Primary Care Provider (PCP) improves your health care. Having a PCP means you will have someone you can turn to for health care advice — whether it’s preventive care, treating common illnesses and injuries, or recommending a specialist when you need one.

When you renew your plan, your health insurance company will match you with a PCP, in part and when possible, based on the physician you have been seeing. If you have not been seeing a specific physician or are renewing with a new health insurance company, that company will match you with a physician as near to your home as possible. You can change this match AT ANY TIME by contacting your health insurance company.

Having a PCP does not change your PPO/EPO, but is an added feature. You may still access any provider, inside or outside the network for PPO’s and inside the network for EPO’s, and do NOT need a referral to access specialists.

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