FROM 

COVERAGE 

TO CARE

Discussion 

Guides for 

Community 

Partners
Use with Roadmap

FROM 

COVERAGE 

TO CARE

A Roadmap 

to Better 

Care and a 

Healthier You

What’s Included

This booklet has information and talking points to 

support community organizations with helping the 

newly insured understand their coverage. 

You’ll find discussion guides for talking with

consumers about: 

• How to stay healthy

• The basics of health insurance and the Affordable 

Care Act

• Finding a provider and making appointments.

There’s also information about fostering community partnerships between organizations that care 

for underserved communities, including:

• Ways to help community organizations build

relationships with organizations inside and outside the health care delivery system

• Resources that organizations can use to help 

this process. 

Developed by the MITRE Corporation and the RAND Corporation for CMS.
DISCUSSION GUIDES

for Community Partners

FROM COVERAGE TO CARE:

Y

our organization is among the many community 

organizations (like social service and volunteer organizations, health insurance assistors, community- and 

faith-based organizations, and health care provider offices) 

that will play a major role in helping the 40 million new 

consumers who are now eligible for coverage understand: 

• What it means to have health insurance 

• When and where to seek health services 

• Why prevention and partnering with a provider is important for having the best health. 

Many of the newly insured have little or no experience 

with health insurance or available health care services 

and may need to rely on organizations they trust like 

yours to help them work through the health care system. 

Organizations like yours are an important resource in 

the community for providing information and necessary 

services to the populations you serve, especially if they 

include hard-to-reach populations. Your organization 

may have a better understanding of how to motivate 

your community to seek health care services on a regular basis. 

You can use the information and resources in this 

booklet to start conversations with consumers about the 

importance of health insurance and how to navigate the 

health care system. 

How to use this booklet 

There are two sections: 

1. THE FIRST SECTION is about how to talk to 

consumers about key health and health care topics. 

Each topic has three parts: 

What to say

“What to Say” helps you lead discussions and make 

key points.

Key questions

“Key questions” helps you prompt discussions on

these topics.

Resources

“Resources” helps you and your communities learn 

more about each topic in this booklet. 

We encourage you to use your available resources to communicate about these topics. For example you can: 

• Post relevant information on community bulletin boards or in 

newsletters you already use, and/or host community-wide 

discussions on these topics and empower participants to do 

the same

• Share this discussion guide and the Roadmap with staff at 

your organization so all those who work with consumers and 

patients are better prepared to answer questions and support 

the newly insured

• Talk about health care across many settings. Consider sponsoring or participating in a health fair, or using social media.

2. THE SECOND SECTION is about how community 

organizations can work together to better support the newly 

insured.

The information and resources in this booklet are 

meant to be used along with the booklet “From 

Coverage to Care: A Roadmap to Better Care and a 

Healthier You,” which you can also give to people in 

your community. There are some references in the 

Roadmap to help guide your discussions.

?

Consumers

TALKING TO

TALKING TO CONSUMERS

How to stay healthy

Some of the newly insured may not think about using their coverage to stay healthy. You may need to 

help them understand the connection between their new plan and good health, getting regular care, 

and forming healthy habits. You may want to explain that even though they may not feel sick, it’s still 

important to have regular checkups and get preventive services. 

What to say

Getting Regular Checkups

The Centers for Disease Control and Prevention (CDC) states that regular health exams and 

tests can help find problems before they become 

serious. Under the Affordable Care Act (ACA), most 

plans have to cover many preventive services at no 

cost to you. 

During your regular check-ups, you and your 

doctor can decide which preventive services are 

right for you. For example, your doctor can help you 

think about:

• Are you getting the right screenings? Screenings are 

tests that look for diseases before symptoms appear. 

Blood pressure checks and tests for high cholesterol 

are examples of screenings. 

• Should you be taking preventive medicines, and do 

you need any immunizations or shots? Examples 

of this include taking aspirin to help prevent heart 

disease if you’re 45 or older, and getting a flu shot.

• Should you consider changes in your lifestyle, such 

as making healthier food choices, quitting smoking, 

and/or exercising more? Changes such as these can 

go a long way toward keeping you healthy.

Don’t be afraid. Some people are afraid to see a doctor or other practitioner because they worry about finding something wrong with their health. But if you go to 
the doctor regularly, he or she may be able to

notice any changes in your health earlier than you 

would otherwise notice. Your doctor will work with you 

to decide on the best treatment for you. Sometimes 

this means making a change to your health habits, 

taking medicine, or undergoing a medical procedure.

Forming good health habits

By getting a regular check-up, you can

learn how your age, gender, family history, 

and health behaviors affect your chances of 

living a longer, healthier life. You might also

learn how to:

• Be physically active: Regular exercise reduces the 

risk in adults of early death, coronary heart disease, 

stroke, high blood pressure, type 2 diabetes, colon 

and breast cancer, and depression. It can improve 

thinking ability in older adults and help you to stay 

mobile and able to care for yourself. 

• Make healthy food choices: Eating vegetables, fruits, 

whole grains, and fat-free or low-fat milk products 

as part of your diet can help protect you from heart 

disease, type 2 diabetes, and some types of cancer. 

Eating healthy also means limiting foods that contain 

cholesterol, sodium (salt), and added sugars.

• Achieve and maintain a healthy weight: Exercising 

and making healthy food choices are essential for 

achieving and maintaining a healthy weight. To stay 

at a healthy weight, try not to eat more calories than 

you use up. 

• Be tobacco free: Quitting smoking is one of the most 

important things you can do for your health. The 

sooner you quit, the sooner your body can start to 

heal. You’ll feel better and have more energy to be 

active with your family and friends.

• Manage stress: Not all stress is bad. Stress can help 

protect you in a dangerous situation. But preventing 

and managing ongoing stress can help lower your 

risk for serious health problems like heart disease, 

obesity, high blood pressure, and depression.

Key questions

1 Do you have questions or concerns about 

your health? You can ask your doctor at your regular 

check-up. A check-up is like a tune-up for your car—

your doctor will check many aspects of your health, 

and you can talk to him or her about any changes you 

could make to stay healthy or feel better. 

2 Are you unsure how to change your routines 

to feel less tired, have better habits, or eat healthier? Asking your doctor about how to live your life in 

a healthier way during your regular visit can help you 

make small changes that make a big difference.

?
Resources

• Visit healthfinder.gov to get basic information about 

staying healthy (for Spanish, visit healthfinder.gov/

espanol/). Also, as part of its effort to improve the 

quality, safety, efficiency, and effectiveness of health 

care for all Americans, the HHS Agency for Healthcare Research and Quality (AHRQ) has produced 

audio podcast series on many health topics, including how to get through the health care system. To 

listen, visit healthcare411.ahrq.gov/ (for Spanish, 

visit healthcare411.ahrq.gov/defaultes.aspx).

• Visit ahrq.gov/patients-consumers/prevention/

understanding/bodysys/index.html for a brochure 

with easy-to-understand explanations of body systems and disease conditions. 

• Visit uspreventiveservicestaskforce.org/

recommendations.htm to see what preventive

services you and your family should get to live a 

healthy life.

• For a list of vaccines and immunizations you need to 

be protected from illness, visit cdc.gov/nip/

adultimmsched. 

• To get more information on creating a healthy diet, 

visit choosemyplate.gov/food-groups/. The Center for Nutrition Policy and Promotion (CNPP) was 

established to improve the nutrition and well-being 

of Americans (for Spanish, visit choosemyplate.gov/

en-espanol.html). 

• For more information on weight, such as how to 

calculate your body mass index (BMI), go to the 

CDC’s BMI Calculator at cdc.gov/healthyweight/

assessing/bmi/adult_bmi/english_bmi_calculator/

bmi_calculator.html. 

› To get the calculator, or any other information 

 on CDC’s website in Spanish, visit www.cdc. 

 gov/spanish/.

› To learn about the Physical Activity Guidelines 

 for Americans, visit health.gov/paguidelines/

 guidelines. 

 • To get tips on how to quit smoking, visit www.

smokefree.gov. To talk to someone about how to 

quit, call the National Quitline at 1-800-QUITNOW 

(784-8669).

• Get more information on managing stress at 

healthfinder.gov/HealthTopics/Category/healthconditions-and-diseases/heart-health/managestress#take-action_1.
TALKING TO CONSUMERS

Health insurance and the ACA 

Many consumers who are new to health coverage need information about what health insurance is, 

how it works, and how to use it. Below are some points you can use to explain health insurance 

and to talk about other new benefits offered by the ACA.

What to say

Insurance basics

In many cases, health insurance may help to 

pay for your medical costs and services.

Different insurance companies offer a variety 

of plans, and each plan works a little differently. Make sure you know how your plan works, 

what services your plan covers, which providers you 

can see, and how much services will cost. 

• Some plans have copayments. A copayment is 

a fixed amount (for example, $15) you pay for a 

covered health care service, usually when you get 

the services. The amount can vary by the type of 

covered health care service. 

• Coinsurance is your share of the costs of a covered 

health care service, usually calculated as a percent 

(for example, 20%) of the allowed amount that the 

plan will pay for the service. You generally pay coinsurance plus any deductibles you owe. Your plan 

may require you to make a copayment for some 

covered services and to pay coinsurance for other 

covered services.

• Some insurance plans have a deductible. A deductible 

is the amount you owe for health care services your 

health insurance covers before your health insurance 

or plan begins to pay. You may have separate deductibles for medical care and prescription drugs.

• Some insurance companies have what are called 

“networks”—these are the facilities, providers, and 

suppliers your health insurer or plan has contracted 

with to provide health care services. You can see 

a provider who is out-of-network, but you might 

have to pay more. Talk to your insurance company if 

there’s a provider you want to see who isn’t in your 

network so you can understand the costs.

• If you have internet access, many insurance companies offer a website where you can create an account 

and read about your benefits and copayments, find a 

provider in your network, reprint your insurance card, 

review any claims you have made, and learn how to 

contact your insurance company with questions.

When you sign up for insurance, you may get a 

card or other paperwork from your insurance 

company with important information on it. Cards 
from one insurance company may look different than 

cards from another insurance company but generally 

have the same information on them. For example, a card 

may include your name and member number, your group 

number (used to track the specific benefits of your health 

insurance plan), copayment and coinsurance, and phone 

numbers that can be used to call your insurance company with questions.

• Keep your card available and in a secure place. Never let someone else use your insurance card. If lost, 

report it to your insurance company immediately.

1 Do you understand important terms related 

to health insurance like copayment, coinsurance, 

deductibles, premium, and provider “networks”? 

These words are important because they relate to how 

much you’ll pay for health care and services. If you don’t 

understand them, or aren’t sure how each of these applies to your health plan, talk to your insurance company 

so there are no surprises. 

2 What new benefits under the Affordable Care 

Act are you the most interested in learning more 

about? There are many resources available on the 

new ACA benefits—all you have to do is start asking.

Resources

• In Step 2 (page 7) of the Roadmap, we’ve provided a 

graphic of what a health insurance card might look 

like and the information it might have. Please feel 

free to copy and give this out.

• The Roadmap also has a glossary that defines insurance terms like copayment and deductible. You can 

use this to help explain these terms to consumers.

• Visit HealthCare.gov to answer questions you or 

your community members may have about the 

insurance benefits and services that are available 

because of the ACA. For Spanish, visit

CuidadodeSalud.gov. 

• Visit the White House website at whitehouse.gov/

healthreform to find out what’s happening in your 

state concerning the ACA.

How the Affordable Care Act Has Changed How Insurance Works

• Insurance companies generally can no longer deny coverage to 

people because they have a preexisting condition—a disease 

or health condition that started before the person got insurance.

• Insurance companies generally can’t take away your coverage 

if you get sick.

• Insurance companies can’t set a lifetime limit on how much 

they’ll pay or how much treatment you can get.

• All new plans have to cover certain procedures that will keep 

you or your dependents healthy, including cancer screenings, 

counseling on quitting smoking, routine vaccines, and regular 

“well-baby” and “well-child” visits at no extra cost. These are 

called preventive services and are fully covered without any 

cost to you even if you have a copayment for other services.

• If an insurance company refuses to cover a service, it might 

have to offer you a chance to appeal that decision.

• Women generally don’t need a referral from another provider to 

get care from an obstetrician/gynecologist (OB/GYN).

• Children generally can stay on their parents’ insurance plan

until age 26. 

Key questions

?
TALKING TO CONSUMERS

Finding a provider and making a visit

I

t’s important that consumers build a long-term relationship with a provider who knows their background and health history and understands what’s important to them. Making an appointment is a 

critical first step in connecting with a provider and enabling healthy behaviors. As a result, it’s important that consumers understand what to do and what to expect during this visit. Below are some 

talking points you can use to talk to consumers about choosing a provider and preparing for their visit 

with the provider.

What to say

Finding a provider 

Choosing a provider is an important first step in 

getting care, and if you do a little homework, you’ll 

find a health care provider who’s right for you.

Insurance companies often have what are 

called “networks”—these are the facilities, 

providers, and suppliers the health insurer or plan 

have contracted with to provide health care services. In some cases, you will have to see a doctor 

who’s in their network if you don’t want to pay more 

than your copayment or coinsurance amount for a 

covered service. 

• If your plan uses a network, start your homework with 

your plan’s list of “in-network” providers. This list may 

be available online through your insurance company’s 

website. Sometimes you can see a provider who is outof-network. Talk to your insurance company if there’s 

a provider you want to see who isn’t in your network 

because you may have to pay more to see them. 

For your regular and routine health care, it’s 

important to choose a primary care provider, or 

PCP. Primary care providers include general practice, 

family practice, internal medicine, pediatrics, and, 

in most cases, obstetrics and gynecology. Your PCP 

will be the person you see for your check-ups and 

can be your main point of contact for staying healthy. 

Your PCP might be a doctor, a physician assistant, a 

highly trained nurse, or certain other medical professionals, and you might visit them in a private office, a 

large medical building like a hospital, or a community 

health center.

• When you sign up for insurance, your plan might 

assign a primary care provider to you. You might be 

able to change providers, but each plan has its own 

rules on how to do that. Talk to your insurance company to find out how to make this change.
• In some cases, you may prefer to choose your 

providers based on recommendations from friends, 

family, or a trusted community group or organization. 

• When you’re talking to friends and family about their 

health care experiences, you might want to ask: 

› What providers do you and your family see?

 Are there other providers you hear good things 

 about?

› What do you like about your provider? Are there 

 things you don’t like? 

› Is it easy to get an appointment with the

provider?

› Does the provider spend enough time with you, 

 and does he or she explain things in a way that 

 is easy to understand?

› Is the provider and office staff respectful of your 

 culture or language preferences?

› Is the office staff friendly and helpful?

• Sometimes you can also find information about 

providers on the internet to see what other people 

say about them.

• In some neighborhoods, community health centers 

offer a wide range of health care services. You can 

choose to see a provider at one of these centers, but 

check with your insurance company to find out how 

much you will have to pay if you get services at a 

community health center.

Sometimes you’ll need to see a specialist—for 

example, if you need an allergy doctor or a foot doctor 

(podiatrist). If your primary care provider refers you to 

a specialist, you might also need to make sure that the 

specialist is in your plan’s network. You may also have 

to pay more to see the specialist, even if he or she is in 

your plan’s network.

Making an appointment with a health care provider

Making an appointment is the first step in connecting with your provider and starting healthy 

behaviors.

• When you call the provider’s office, ask them if 

they’re accepting new patients.

• When you call, let them know whether you’re a 

current or new patient. If you’re a new patient, they 

might ask you a lot of questions. They may ask you 

for your name, date of birth, address, and information about your insurance. You may also be asked 

about the reason for your visit.

• You may have to wait a few weeks for a well-visit as 

providers often reserve some appointments for those 

who are sick and need to see the provider sooner. If 

you’re sick and need to see the provider sooner, let 

them know this when you call. 

Preparing for the visit

Before your visit, think about any questions or 

concerns you have about your health. You may 

want to write them down so you don’t forget to ask. 

You should show up early to your first appointment. 

There may be forms you need to fill out before you 

see the provider.

Some providers charge you a fee if you’re late or 

don’t show up for your appointment. If you can’t 

make your appointment, you should call as soon as possible before your scheduled appointment to change it. 
Bring your insurance card and a photo identification. Your provider office might need this information before you see the provider.

Bring a list of current medicines you’re taking, 

including how much you take, how often you take it, 

and why you take it.

Your provider is there to help you stay well. 

But they can do their job much better if you talk with 

them about your health and any concerns you have. 

You should also ask lots of questions to make sure you 

understand what the provider tells you. If your provider 

says something that doesn’t make sense, speak up. 

Make sure you know what you should do if you have 

questions or concerns once you get home.

Stay in touch with your provider. Your provider can 

help answer questions you have about your health, figure out when you need to come in for a visit, and even 

change any medication you are on if it’s making you feel 

sick. They are there to help you—use them.

Key questions

1 Do you know where to start your search for a 

new provider? Contact your insurance company, look 

on your health insurance company’s website, or look 

in your insurance handbook to find out which providers are near you and will accept your insurance. Your 

friends and family may have suggestions, too. 

2 Do you have one place where you write down 

all of the medicines you and your family members 

take, and the different conditions or health problems 

that come up? Keeping a list handy for each member of 

your family with your health questions and medicines is a 

helpful way to make the most of your visit to the doctor. 

3 After the visit, do you understand how your 

health is? Do you know what you’re supposed to 

do to stay healthy, what you’re supposed to do 

next, and, if you have a health condition, what it is 

and why it’s important to your health? If you don’t 

know the answers to these questions, ask the provider 

to explain the information to you in a different way. 

Write it down or ask your provider to write it down so 

you can look at it when you get home. Don’t leave the 

provider’s office until you understand your health.

Additional resources: In Step 3 (page 8) of the 

Roadmap, we provide more suggestions for finding 

the right provider. Please feel free to copy and hand 

out this list.

Helping newly insured consumers understand what to 

expect during the first visit will help to ensure that the 

experience is a positive one and is effective for the 

consumer. Refer to Step 5 (page 12) of the Roadmap 

for a list of potential questions consumers may ask 

their provider to ensure they understand their health 

and steps needed to become healthier.

• To learn more about choosing the right physician, visit 

the Agency for Healthcare Research and Quality website at archive.ahrq.gov/consumer/qnt/qntdr.htm.

• To identify the location of community health centers 

in your community, visit findahealthcenter.hrsa.gov.

• To get location and other information 

about tribal medicine, visit ihs.gov/index.

cfm?module=AreaOffices.

Resources

?
Community Organizations

TALKING TO OTHER

COLLABORATION AND OPPORTUNITIES TO WORK TOGETHER

To Help the Newly Insured

Community organizations like yours (including social service and volunteer organizations, health 

insurance assistors, community- and faith-based 

organizations, and health care provider offices) are 

often considered trusted partners in the community. 

In many cases, your organization might work with 

underserved communities to provide direct services, 

information, or help with linking community members with other resources in the community. 

The first part of this guide provided some talking 

points and resources to support consumers as they 

navigate the health care system. This section provides information on how your organization might 

want to start reaching out to other community 

organizations. It includes some questions to help 

your organization think about what it needs for collaborating with other organizations and what your 

organization can bring to the table to help others. 

You should tailor the information and approaches 

as needed to reflect your organization and opportunities for collaboration in the community. 

In your community, there are other organizations 

that share your organization’s interest in meeting 

the health and health care needs of the populations 

your organization serves, even if the organization 

itself is not a health care delivery organization. 

These organizations may have a complementary 

set of resources, expertise, and community outreach that, together, your organizations can use 

to help consumers enter the health care system 

and stay engaged in their health care over the long 

term. 
Specific activities your partnership 

might undertake include:

•Help consumers get the information and resources they 

need to start and maintain ongoing relationships with 

their providers by: 

> Helping people identify where to go for care 

> Working with consumers to read and understand 

information in their insurance materials 

> Staying in touch with consumers after they obtain 

insurance to help in the event that they have 

difficulty accessing care under their new plan

> Conveying information about community resources 

available to consumers to facilitate access to health 

care, such as financial support for food, housing, or 

transportation services

> Linking consumers to the resources they can 

use to stay healthy—for example—exercise and 

nutrition resources and activities, and screenings for 

conditions like high blood pressure, cancer, and HIV.

• Help consumers access health care and related 

services by:

> Offering transportation to health care appointments, 

child care (for parents going to the health center), 

translation, and case management

> Collaborating with other organizations and providers 

to identify problems and develop solutions

> Helping consumers understand their rights 

and options to appeal decisions made by their 

insurance plan.
Below are some steps you can take to start 

developing these partnerships, and some 

resources you can use to support this effort.

Step 1: Make a list of your organization’s

expertise, assets, and services

• Who do you serve? Historically underrepresented 

populations (like racial and ethnic minorities)?

• What services do you currently provide (direct health 

care, translation, health education, mental health, 

spiritual support, etc.)?

• What expertise could you offer other organizations—

what do you have that they could really use?

• What are you looking for to support your effort/

mission? What type of partner would really help?

• Do you have existing relationships with organizations 

that you think could be strengthened around these 

issues?

Step 2: Identify community organizations

• Are there organizations in the community that you 

would like to partner with?

• It may help to identify information about the populations you serve:

› What are the other social services that this group 

uses?

› What other organizations do residents in your 

community rely on for important information? Do 

they provide health and health care information?

› What are the existing ways of getting messages 

out to the community?

• Use many resources ranging from the yellow 

pages to neighborhood or city directories that are 

often published by city or county officials, or other 

community organizations. For example, your local 

chamber of commerce may publish a list of local 

businesses.

• You can also talk to colleagues and residents to 

identify other organizations that don’t appear on 

these lists.

• Narrow the list of organizations and think about 

what each organization provides and how it might 

complement your organization’s efforts.

• Use “asset mapping” to identify the resources that 

are available to support health and health care in a 

community. Consider starting this process in your 

community. We provide a few links in the Resources section to help you learn about this process.
Step 3: Make that initial contact

• Find out who the point of contact is in the organization you want to work with.

• Call or email and ask for a meeting to introduce your 

organization. 

• Let them know what organization you’re from, and 

give them information about your organization.

• If you’ve engaged in an asset mapping process, you 

can share the results with them.

• Tell them why you called or what made you think 

of them. For example, have you been struggling 

with how to answer some questions for individuals 

you serve? Are you looking for a resource that can 

strengthen the cultural or linguistic responsiveness 

of your organization? Are you trying to help individuals find providers close to them and navigate the 

health care system to make an appointment but 

don’t know where to start? 

• Note that you’re interested in learning more about 

them and whether there might be a way that you can 

start to work together. Let them know what you can 

bring to the table as well.

 Step 4: Have the meeting

• Talk about how you want to start collaborating. 

How might that work? What would it look like? 

What would each organization bring to the table? 

You may want to start small, on a specified task, 

particularly if you’re not as familiar with the other 

organization. This will give you a chance to get to 

know each other.

• Remember to give before you receive: giving to 

others first is one of the best ways to build relationships. Ask the partnering organization how you can 

contribute to its effort.

Step 5: Continue the dialogue

• Partnerships don’t happen overnight. In many cases, 

it may take several conversations before you feel 

comfortable working together. That’s okay.

• Talk about other community organizations you may 

want to invite to the table. Is there a way to leverage 

your initial dialogue to include others who may be 

similarly interested in collaborating?

• There is no such thing as a static list of resources in 

your community. Rather, organizations will come and 

go over time. You should expect to “refresh” your list 

of potential partners as time goes on. 
Resources

• For more information on developing partnerships, 

access the pamphlet “Community Engagement and 

Partnerships to Improve Access to Medical Homes 

to the Community Tool Box” at the National Center 

for Cultural Competence. Visit www11.georgetown.

edu/research/gucchd/nccc/documents/NCCC_PP_

Medical%20Homes.pdf and the Community Tool 

Box at ctb.ku.edu/en/creating-and-maintainingpartnerships#node_toolkits_full_group_outline.

• To find the organizations that are providing in-person 

assistance in your community, visit localhelp.

healthcare.gov. People can type in their city, state, or 

zip code to find help. Note: For state marketplaces, 

go to the state’s website for more information. 

• To find the community health centers in your community, visit findahealthcenter.hrsa.gov.

• To learn more about asset mapping, visit the National 

Association of County and City Health Officials at 

naccho.org/topics/infrastructure/CHAIP/upload/

Asset-Mapping.docx or the UCLA Center for Health 

Policy Research at healthpolicy.ucla.edu/programs/

health-data/trainings/Documents/tw_cba20.pdf.

• To understand how health care organizations

can improve minority health and foster equity,

review the Roadmap to Reduce Disparities at

solvingdisparities.org/tools/roadmap. The Roadmap’s six-step framework provides guidance for 

incorporating disparities-reduction efforts into the 

quality improvement efforts of health care organizations. It’s designed so that various components of 

an equity-focused quality improvement agenda can 

be developed and implemented separately, simultaneously, or maintained throughout.
Your ROADMAP to health

Reprinted from: From Coverage to Care: A Roadmap to Better Care and a Healthier You

Start 1 here 

Put your 

health first.

• Staying healthy is important 

for you and your family.

• Get a regular check-up.

• Keep all of your health 

information in one place.

Understand your 

insurance plan.

• Check with your insurance 

plan to see what services 

are covered by your plan.

• Be familiar with your 

copayments, deductibles, 

and coinsurance.

• Know the difference 

between in-network and 

out-of-network.

2

Find a provider.

• Ask people you trust.

• Check your plan’s provider 

network.

• If you are assigned a 

provider, contact your plan 

if you want to change.

• Do research on the internet.

3
4 Make an appointment.

• Mention that you are a new patient.

• Provide the name of your insurance 

plan.

• Tell them the name of the provider 

you want to see and why you want an 

appointment.

• Ask for days or times that work

for you.

5 Be prepared for the 

first visit.

• Have your insurance card with you.

• Make a list of any medicines you are 

currently taking.

• Bring a list of questions and things 

to discuss with the provider and 

write notes during your visit.

• Bring someone with you to help if 

you need.

6 Decide if you like 

the provider.

• You should feel comfortable 

with who you see.

• You should understand and 

be able to communicate 

with your provider.

• Remember: It is okay 

to change to a different 

provider!

No

Yes

7 Next steps after your appointment.

• Follow your provider’s instructions.

• Fill any prescriptions you were given.

• Schedule a follow-up visit if necessary.

• Contact your insurance plan or provider 

with any questions.