Under the Affordable Care Act, you have the right to choose any doctor as your primary care physician (PCP), as long as they are available in your health plan's network, contracted with your insurance company and accepting new patients. Women can select OB/GYNs as their PCP, if they so choose, and parents can select a pediatrician as their child's PCP.*
Here's what's different
In the past, health plans could prohibit a member from choosing an OB/GYN or pediatrician as a primary care provider. Now you can choose any doctor you like as long as they care in network, with your insurance company and accepting new patients.
How it impacts you
If you use a doctor who's in your plan's network, you get free access to preventive services like:
- You can choose any available in-network primary care provider to be your primary care doctor, including an OB\GYN. You can choose any available participating pediatrician to be your child's primary care doctor.
- You are not required to get a referral before seeking care from a participating OB\GYN.
Does my primary care provider have to be in my plan's network?
Under the law, do I need a referral to see an OB/GYN?
No. You are not required to get a referral before seeking care from an in-network participating OB\GYN.
Can I choose a pediatrician as my child's primary care provider?
Yes, as long as they are in your health plan's network and are accepting new patients.
*Have health insurance under a grandfathered plan? If so, you might not get these benefits. If there is any difference between the information on this website and your health plan, your policy's provisions will apply.