Finding a doctor doesn’t have to be stressful. We know health care can get complicated. But BlueCross BlueShield of South Carolina has resources to help. 

Here’s how to find the right care for your health needs. 

What kind of care do I need? 

There are different types of doctors. Figuring out what sort of care you need is the first step to finding a doctor.

Your primary care physician (PCP) is your general doctor. He or she can help you find other doctors for more specialized care. It is important for everyone to have a trusted PCP. 

Your PCP is your home base for your health care. PCPs generally practice what’s called “family medicine.” This care is generally given by a doctor trained in family medicine, internal medicine, pediatrics, or obstetrics and gynecology (OB-GYN). 

You don’t have to have kids to have a family doctor. Doctors who practice internal medicine may be a good fit for someone focused on prevention or living with a complex condition. 

Doctors who have undergone advanced training in a specific area of medicine are commonly referred to as a specialist. There are more than 130 medical specialties. Some common examples include: 

• OB-GYN for reproductive health 
• Dermatologist for skin care 
• Allergist for allergies and asthma 
• Cardiologist for heart health 
• Gastroenterologist for digestive health 
• Orthopedist for musculoskeletal issues

Your PCP is your partner in finding specialized care as you face more complex health issues. Find a trusted doctor that helps you feel comfortable speaking up so that you have a voice in your care and who is on your care team.

You can use our tools to ensure your providers meet the criteria that is important to you. You can request a referral to a specific specialist. 

Having a trusted PCP can also save you money. Go to your PCP to seek medical help rather than an emergency room for nonemergent problems such as a cold or infection. It is cheaper to visit a doctor’s office than an emergency room for nonemergency reasons. 

Who is in network? 

Your health plan has a network of doctors and providers that we work with closely to help you access quality care. We have contracts with hospitals and doctors across the state. 

Using an in-network provider will help you access our discounted rates. 

This means lower costs for you. It also means you don’t have to submit claims. We work with in-network doctors to handle this on your behalf.  

If you use an out-of-network doctor, you may have to pay part or all of the bill yourself.  

You can find in-network doctors through our member portal, My Health Toolkit^®. 

What doctor is right for me? 

Pick your care, your way. You can shop for the right care for you and your family, even if you have been referred to a specific doctor. We’ve got tools to make it easy. 

When looking for a doctor, think about what is most important to you. 

Ask these questions to narrow your search: 

• Do you want to see a doctor near your work or home? 
• Do you have a gender preference for your doctor? 
• Do you need your doctor to speak a specific language? 
• Do you want to have the option to see a doctor online through telehealth? 
• Do you prefer a specific health system? 

How do I find a doctor? 

The Shopping for Care option in My Health Toolkit helps you find providers in just a few steps. 

Make sure you log in to your account so that you see network-specific details for your health plan. 

Certain plans will list providers according to tiers. This gives you even greater control over out-of-pocket costs. 

You may see special awards or designations. This lets you know a doctor has proven expertise in a specific area of care. 

You can see side-by-side comparisons and search for doctors who are accepting new patients. 

How do I schedule an appointment with a doctor? 

Once you’ve found a doctor, you will need to schedule an appointment as a new patient. 

If you are connecting with a new PCP, contact his or her office to schedule a new patient appointment even if you aren’t sick. This is routine. 

If you are seeing a specialty doctor as a new patient, the office may want you to have a referral from another doctor. For example, your PCP may reach out on your behalf to request the appointment. 

If referral through an existing doctor is not an option, you may need to contact the office directly and share additional information on your medical history. 

Either way, many specialty doctors expect to have medical records to review in advance of your appointment. 

A few reminders: 

• Have your health insurance card ready when you call. You can find your member ID on the front.
• A current version of your ID card is always available in My Health Toolkit if you need it. 
• The name on your card and member ID are the same for everyone on your plan. 

What happens after my visit? 

You can check your Explanation of Benefits, or EOB, through My Health Toolkit. This recaps the conversation between your health insurance company and your health care provider any time you receive care.

An EOB is not a bill. It is a tool that you should reference when paying a doctor’s bill. 

Do I have to keep the same doctor? 

Your health is important. It is your choice what doctors you see. If you are not satisfied with your current doctor, you have the right to search for a new one. It is also acceptable to request a second opinion around a diagnosis or care plan related to your health.