The State of New Jersey
NJ Department of Banking and Insurance

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2008 New Jersey HMO Performance Report
Taking Responsibility for Your Health Care

Getting involved in your health care can help you get the most from your health coverage.

Know the Rules

  • Understand what services your health benefits plan does and does not cover by reading the evidence of coverage or talking to your employer.
  • Know how to choose or change your primary care physician.
  • Understand how to schedule appointments for check-ups and when you are sick.
  • Know when you need referrals or preauthorization for a procedure and how to get them.
  • Know what you are required to do when using a hospital or emergency room.

Stay Informed

  • Learn about any new policies affecting how the HMO and your health benefits plan works by reading member newsletters and checking the HMO’s web site.
  • Know the telephone numbers and hours of your physician’s office and of the HMO’s member services department. Carry them in your wallet or purse in case of emergency.

Keep Records

  • Write down your health concerns and keep a list to discuss them with your doctor.
  • Create health files to keep track of the care and services received by you and members of your family.

Take Charge

  • Take good care of your health by making appointments for check-ups and preventive care.
  • Talk with your doctor about when you need regular health screenings.
  • Call member services if you don’t understand information that the HMO or provider sends you.
  • Ask for a better explanation if you don’t understand the answers to your questions.

Choose a Doctor Carefully

  • Ask for recommendations from medical societies, health care providers, referral services, hospitals, family members and friends.
  • Get information about the doctor’s training and experience from the HMO or the doctor.
  • Ask if the doctor is board certified in his or her specialty area.
  • Check whether prospective doctors have had any disciplinary actions issued against them.

Click here for more information on New Jersey physicians

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New Jersey Department of Banking and Insurance