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Value of a Primary Care Provider

Want to get and stay healthy while saving money? Having a PCP can help. With a PCP, you’ll have somebody in your corner ensuring you get the care you need. If you don’t already have a relationship with a PCP, find one with Provider Finder and schedule a wellness exam.

The benefits of having a PCP include:

  • People who see a PCP tend to live longer, healthier lives.
  • A PCP gets to know you, your medical history, treatment preferences, medication and lifestyles.
  • A PCP can help manage chronic conditions like asthma or diabetes.
  • A PCP provides routine medical care. This may identify early signs of chronic conditions, such as high blood pressure or stress. Together, you can develop a care plan.
  • You can often schedule a same-day or virtual appointment with your PCP for non-emergency medical issues like colds, flu, rashes, or ear infections.

How to Change Your Primary Care Provider

If you're enrolled in TRS-ActiveCare Primary or TRS-ActiveCare Primary+ plans, you can follow these steps to select or change your PCP:

  1. Select the plan you are enrolled in above.
  2. If you know the name of the PCP you want, you can search by Name and Specialties.
  3. If you don’t have a PCP in mind, you can Browse by Category and select Medical Care.
  4. Next, select Primary Care.
  5. Then choose Family Practice, General Medicine, Internal Medicine, Obstetrics & Gynecology, or Pediatrics to narrow your search.
  6. Pick a PCP from the providers listed and click on View Profile.
  7. Locate the 10-digit provider ID number at the very top of the page under Provider Highlights. You'll need this number.

Once you have chosen a PCP, you can update your PCP on file anytime by:

Your change will be effective the first day of the following month. If you need the change to take effect sooner, call a PHG.

Annual Wellness Exam Expectations

Once you've scheduled an annual wellness exam with your PCP, you may be wondering how your wellness exam will go.

During your exam, your PCP will likely:

  • Perform a physical exam, including measuring your weight, height and blood pressure.
  • Request lab and blood work.
  • Develop a plan to achieve your health goals.
  • Discuss your chronic conditions and coordination of care, if applicable.
  • Recommend routine screenings, immunizations and other preventive care.
  • Talk about your health history and lifestyle.

You can also use this helpful preventive services checklist to prepare for your next appointment.

Questions To Ask Your PCP

It can be overwhelming when you go to your PCP for your wellness exam. Preparing questions ahead of time can help you get the answers you need.

Some questions you may want to ask your PCP include:

  • Am I at a healthy weight? Has my weight changed a lot since my last wellness exam?
  • Are my feelings of sadness, anxiety, or stress normal?
  • Are the supplements I’m taking worthwhile?
  • What should I be eating?
  • What's the best exercise plan for me?
  • How can I reduce or stop some of my medications?
  • What changes should I make in my lifestyle based on my age and habits?
  • Something doesn’t feel right – can I ask you about it?
  • What should I work on before my next visit?
  • What's the best way to communicate with you if I have questions? Do you text or use email? Are you the one answering these messages?

Does Your Plan Require a PCP?

TRS-ActiveCare Primary and TRS-ActiveCare Primary+ plans require a PCP. 

Think of your PCP as the team captain for your medical care. If you do need a specialist referral, they’ll arrange this for you while continuing to manage your overall care. You should go to them first any time a non-emergency medical problem arises.

View more information about referrals

Do I need a referral to see a specialist?

If you have TRS-ActiveCare Primary or TRS-ActiveCare Primary+, yes, you do need a referral to see a specialist.

But it's not as complicated as you may think! Here's what you should know about referrals:

  • You don’t need a referral for emergency care, annual well-woman visits, or in-network behavioral health specialists. 
  • You don’t have to ask your PCP for a referral every time you visit a specialist. The specialist will decide how many visits you have in the referral period. 
  • A specialist can’t recommend you to another specialist; only your PCP can. 
  • Changing your PCP during a treatment period with a specialist may change your existing authorization.

Do you have resources for help with referrals?

Yes! We have a web page all about referrals. We've also created two helpful fliers you can download to navigate referral requests:

If you have any questions about the referral process, you can connect with a Personal Health Guide 24/7 at 1-866-355-5999 or chat through the BCBSTX App. They can also help you find an in-network provider, navigate claims and more.