Finding a CHOC Primary Care Physician (PCP)
Call today to schedule an appointment with one of our pediatricians.
We at Rady Children’s Health in Orange County (formerly known as CHOC) know that insurance can be confusing. While Rady Children’s is a healthcare provider, we are not an insurance plan. Patients should always inquire with their plan directly regarding specific coverage questions.
Have questions? Call our general resource line at 714-509-7732.
The basics
Your Primary Care Physician (PCP) and healthcare team are the people who take care of your health.
Your health plan is the insurance company that helps pay for covered healthcare services. The health plan:
- Determines your benefits and coverage
- Collects premiums
- Processes claims
- Contracts with medical groups and healthcare providers
Common Plan Types
HMO (Health Maintenance Organization)
An HMO requires you to choose a primary care physician (PCP) who manages your care and provides referrals to specialists. Your covered services are generally limited to doctors within your assigned group network.
For HMO plans, adults and their dependents may be able to select different medical groups. Contact your health plan to inquire about their process.
PPO (Preferred Provider Organization)
A PPO gives you more flexibility to see doctors and specialists both in and out of the network, although staying in-network usually costs less.
With a PPO, you are not usually required to select a PCP, although many people choose one for continuity of care.
With a PPO:
- You can receive care from both in-network and out-of-network doctor.
- Your healthcare is not tied to a specific medical group or independent practice association (IPA).
- You can see some specialists without a referral.
How can I choose a Rady Children’s Health Orange County (also known as CHOC) PCP?
Patients have a choice within their health plan when it comes to selecting their PCP. Identify the PCP you’d like to select and then check your health plan’s provider directory to confirm that the physician is in-network. If you would like to select a CHOC doctor who is not on your plan’s online directory, reach out directly to your plan to inquire further.
Keeping your doctor if your medical group changes
Network partnerships can change between your health plan and assigned IPA. When this happens, families may need to take action to maintain continuity of care with their doctor.
If you’ve received a notice from your health plan that your current PCP will no longer be available, contact your health plan to inquire about maintaining continuity of care with your PCP. Use the number on the back of your card.
What is Open Enrollment?
Open enrollment is the once-a-year window in which you can sign up for a health plan, renew the one you have, or switch to a new one. It’s your yearly chance to make sure your coverage still fits your family before you’re locked in for another year.
Our Primary Care Network
Our Primary Care Network includes practices across Orange County and beyond.