There are many reasons why a person may need a new doctor. They may have:
They may also need or want a specialist (for example, a doctor who focuses on problems of the digestive system).
It is also possible that their former doctor may have:
If someone you support needs a new doctor, they might want your help. Ask if you can help them locate a doctor.
A quick note on health insurance: It is important to know what kind of health insurance the person you support has before you start looking for a doctor. Most people with developmental disabilities have Medi-Cal. Medi-Cal is a form of health insurance paid for by the government. Many doctors do not accept Medi-Cal payments. Find out if the person you support uses Medi-Cal before you start looking for a doctor. If they do, make sure you find a doctor who takes Medi-Cal payments.
The best way to find a doctor for a person with developmental disabilities is toask the person’s Regional Center service coordinator for recommendations.
You can also try these other ways to find a doctor:
After finding a doctor, you should check and see if they meet the needs of the person you support. Here are some questions you might ask:
Here are some other ways to find out if the doctor can meet the needs of the person you support:
After they find a doctor, the person you support may want help making an appointment with the doctor, or getting to the doctor's office.
If they are worried or confused about going to see the doctor, you can use the following presentations to help explain to them how to get ready, and what will happen when they go:
This tool can help them and you remember questions to ask the doctor:
After the person you support visits the doctor, the doctor will send a bill to the individual, the insurance company, or Medi-Cal. Health insurance usually pays for doctor’s visits, medications, and other medical bills. Different insurance plans pay for different things; Medi-Cal works like a private insurance plan, in that it only pays for certain things.
If the person you support has private insurance, check with their insurance to see what is covered.
Medi-Cal is a health care program for people with low incomes and people who have SSI (Supplemental Security Income).
Many counties have two kinds of Medi-Cal: regular Medi-Cal, and Medi-Cal Health Plans. Both kinds of Medi-Cal give a person the same basic benefits. But there are differences in how a person chooses a doctor and gets care:
Medi-Cal pays for medical services in both programs. The person you support can try one type and see if they like it. Call Health Care Options (1-800-430-4263) or the person’s Regional Center service coordinator to see what the person’s choices are.
What Are My Medi-Cal Choices? Questions and Answers
Guidebook to explain the two kinds of Medi-Cal – Regular Medi-Cal and Medi-Cal Health Plans – and how to choose which kind of Medi-Cal is right for you (Health Research for Action, 510-643-9543)
The Road to Wellness
Accessing Medical Services and Navigating the Managed Care System (California Department of Developmental Services)
Health Care Options
Health Insurance Counseling and Advocacy Program (HICAP)
Last updated on February 12th, 2010