What to Expect at a Doctor’s Appointment

What kind of doctor visit is it?

So, you’re going to the doctor. What kind of visit or care do you need?

Is this a preventive care visit? This kind of care may be covered at 100% by your health plan.¹ Annual check-ups, routine immunizations, and some types of health screenings may be covered as preventive care. This kind of care may also be called "routine care."

Discussing a new or ongoing health issue with your doctor? This is diagnostic care. Your health plan may cover some of a diagnostic visit, depending on where you are with your plan deductible. You may also be required to pay a certain amount toward your visit, as part of your plan coinsurance. Knowing your expected costs ahead of time can save you from surprise bills and better prepare you for your doctor appointment.

What do you need before a doctor’s appointment?

Ahead of a scheduled doctor visit, be aware of the following general information and plan accordingly:

• Review your health plan benefits to see how your medical care and services will be covered for your visit. An annual physical may be fully covered under your plan. If you’re seeing your doctor for a new or existing medical issue, that’s likely a diagnostic visit—non-preventive—which means you may be paying some of the cost. Check your plan benefits ahead of time to be sure.
• Confirm your provider is in-network. You’ll save money if you see a doctor who’s in your health plan’s network. Check your health plan details. If you see a doctor who’s out of network, you could be responsible for the full cost of the visit.
• Bring your insurance ID card, either a physical card or a digital version of it.
• Arrive 10-15 minutes before your visit. This extra time is helpful if you have any paperwork to complete.
• Be ready to discuss your medical history. Have some notes handy that can help you talk to your doctor or nurses about your medical history, past illnesses, surgeries, and any chronic conditions.
• Bring a list of medications. Prepare a list of all prescriptions you’re taking, including over-the-counter (OTC) drugs and dietary supplements.
• Complete any pre-appointment lab work, screenings, or imaging. If your doctor ordered tests ahead of your visit, be sure to complete them. If you’re having lab work done during your visit, ask if you need to be fasting and for how long.
• Bring a list of any questions you want to ask your doctor or provider.
• Need additional help at your doctor visit? Call ahead and let the office know if you need:
  • Handicap parking
  • A wheelchair
  • Help from an interpreter
  • To bring a family member, close friend, or caregiver with you for your visit

What happens during a doctor’s appointment?

Here are some common things you can expect once you’re at a doctor’s office for a visit:

Check-In

When you first arrive, you’ll check in, usually at a main office for the following:

• Insurance verification: You will likely be asked to show your health insurance ID card so the office can confirm your health plan benefits.
• Paperwork: You may be asked to complete forms about your medical history, current health, emergency contacts, and privacy disclosures.
• Payment: Depending on the type of visit and your health plan, you may be required to pay a copay at the time of your visit.

Vital Signs Check

When you’re called back to the exam area, a nurse or medical assistant will usually check your vital signs. These are things like height, weight, blood pressure, temperature, and heart rate.

Doctor Consultation

What your doctor will usually do as part of your visit:

• Ask or confirm the reason for your visit.
• Ask you about any additional health concerns.*
• Review your medical history and any paperwork you completed when you arrived.
• Review the medications and supplements you’re taking, renew expiring prescriptions, etc.
• Provide any physical examination necessary.
• Order additional labs, tests, or screenings, as necessary.
• Provide you with a treatment plan or plan of action for care, if applicable.
• Refer you to a specialist or other provider if needed (some health care plans require you to get a referral from your Primary Care Provider (PCP) before going to a specialist).
• Schedule a follow-up visit, if needed.

*Note: If this is a preventive care visit, it’s important to know that if you discuss any health concerns or issues you may be billed separately for a diagnostic visit. Review your health plan details so you’re aware of how you would be covered for non-preventive care.

What you should do while meeting with your doctor:

Ask questions!

Don’t understand a medical term, a health condition, a medication, reason for a certain lab test or screening? Ask for a definition, or more details.

Is your doctor prescribing or ordering additional tests, specialist visits, imaging, screening, or something else? Ask how that will be covered under your health plan and what the cost may be.

Getting a referral? Find out who the specialist is and location, if they will be in your plan network, and who will be responsible for scheduling that appointment—the doctor office or you.

New prescription? Make sure to confirm your pharmacy of choice. Ask the doctor or medical assistant if that prescription is being automatically sent to your pharmacy or if you’ll get a handwritten paper prescription that you will need to take to the pharmacy.

Ask your doctor or nurse if you have any remaining questions.

What happens after a doctor visit?

Follow your doctors’ instructions and the plan of action to stay healthy, get healthier, or address health concerns as applicable.

• Review your health records: If your doctor’s practice uses an online patient portal you can log in to review your doctor’s visit notes, check lab and test results, verify any follow-up appointments, send follow up questions or messages to your doctor if needed.
• Pick up medications: If your doctor prescribed a medication, make sure to pick it up from your pharmacy and take it as prescribed.
• For health and medical issues, monitor your symptoms: If you develop new symptoms or feel worse, call your doctor.
• Additional appointments: Make sure to follow through with any additional specialist referrals, tests, or screenings your doctor may have ordered as part of your visit.

When planning a visit to the doctor, these general guidelines can help you feel more informed, confident, and comfortable talking with your doctor, asking questions, and getting the care you need.