Another specialty option is the UCSD Health Plan, which works only with Medicare and Medicaid. But, according to Nancy K. White, director of the UCSD Health Plan, there also are regulations stating that the treating physician has to approve any hand-off and be able to finish up any course of treatment already in progress. As far as navigating the maze of specialists, facilities and treatments, White suggests letting your primary physician quarterback your care. In San Diego, most of the time it doesn't matter who your health plan is because if you can stay with the same primary throughout, you'll probably have access to the same specialists and hospitals. Make sure to stay with the same physician group.
Some medical groups make their physicians get permission for every referral to a specialist.
That referral feature is a selling point and varies a great deal from group to group. The trend is to let physicians handle it, to progress from referral management to disease management. Sophisticated medical groups identify those members who might be in danger of deterioration in their health and provide services before they develop a serious condition. When choosing coverage, White suggests doing some anonymous shopping to find out how long it takes to make an appointment. You need to determine whether they're too busy to see you.