This page may have documents that can’t be read by screen reader software. For help with these documents, please call the number on the back of your member ID card.

[+] Feedback Language Assistance En español

Value of a Primary Care Provider (PCP)

Want to get and stay healthy while saving money? Having a PCP can help. With a PCP, you’ll have somebody in your corner ensuring you get the care you need. If you don’t already have a relationship with a PCP, find one today and schedule a wellness exam.

The benefits of having a PCP include:

  • People who see a PCP tend to live longer, healthier lives.
  • A PCP gets to know you, your medical history, treatment preferences, medication and lifestyles.
  • A PCP can help manage chronic conditions like asthma or diabetes.
  • A PCP provides routine medical care. This may identify early signs of chronic conditions, such as high blood pressure or stress. Together, you can develop a care plan.
  • You can often schedule a same-day or virtual appointment with your PCP for non-emergency medical issues like colds, flu, rashes, or ear infections.

Does Your Plan Require a PCP?

TRS-ActiveCare Primary and TRS-ActiveCare Primary+ plans require a PCP. 

Think of your PCP as the team captain for your medical care. If you do need a specialist referral, they’ll arrange this for you while continuing to manage your overall care. You should go to them first any time a non-emergency medical problem arises.

Do I need a referral to see a specialist?

If you have TRS-ActiveCare Primary or TRS-ActiveCare Primary+, yes, you do need a referral to see a specialist.

But it's not as complicated as you may think! Here's what you should know about referrals:

  • You don’t need a referral for emergency care, annual well-woman visits, or in-network behavioral health specialists. 
  • You don’t have to ask your PCP for a referral every time you visit a specialist. The specialist will decide how many visits you have in the referral period. 
  • A specialist can’t recommend you to another specialist; only your PCP can. 
  • Changing your PCP during a treatment period with a specialist may change your existing authorization.

For more information, including questions to ask your PCP about referrals, download the Navigating Referrals flier.

If you have any questions about the referral process, you can connect with a PHG 24/7 at 1-866-355-5999.

Importance of a PCP

Have you found a PCP?

  • View Transcript

    Do you have a doctor?...Like, really. What’s their name? How often do you see them? Do they know your overall health situation? If not, then it sounds like you need to select a primary care physician…

    Finding a primary care physician is a crucial first step in using your health care coverage. And it’s important to see that doctor regularly to start building a relationship.

    Many people with a PPO health plan assume that they don’t need a primary care physician. But nothing could be further from the truth. Everyone needs one! Here’s why…

    The health care system is complicated, right? Primary care physicians – a lot of people call them PCPs – help their patients navigate their health care. Think of your PCP as your first point of contact – the main doctor who coordinates all your care. They’re a designated resource who knows you and your health history – and can connect you with specialists when needed.

    If you have a physician-directed plan from TRS, you need a referral from your PCP to see a specialist.

    If you have a PPO plan from TRS, you do not need a referral.

    Now, you might be thinking… “I’m pretty healthy.” Good for you! A PCP can help you keep things that way.

    They see patients whether they’re sick or well. To stay healthy, you need screenings for things like blood pressure, cholesterol, diabetes and even cancer. Your PCP can handle of those preventive health needs – as well as many non-emergency health issues. Think: common colds, rashes and allergies.

    And studies show that people who have a PCP live longer, healthier lives.

    They are also one of your lowest-cost options for care. Their office visits are less expensive than visits to specialists or urgent care clinics. And most health care plans cover their annual wellness exams at no cost.

    That includes TRS health plans!

    Of course, we don’t always see sickness coming. When it does happen, you’ll be glad you already have a doctor. It’s easier to schedule an appointment when you have an established relationship. Plus, not all physicians are accepting new patients.

    But the good news is – technology is making it easier than ever to see a doctor. Many of them are now seeing patients virtually.

    Designating a PCP is important for you – but it’s also important to the overall health care system. There’s growing evidence that primary care plays a critical role in the future of health care – especially in a new approach called value-based care.

    Spend some time designating a primary care physician for you and your family.

    Insurers like Blue Cross and Blue Shield of Texas offer tools like Provider Finder®, to help you locate a physician.

    To change your PCP at any time, you can call a Personal Health Guide at 1-866-355-5999. Or visit

    Selecting a primary care physician is a foundational first step on your health care journey. Take action today.

Are You up to Date on Screenings, Immunizations and Recommendations?

It’s essential to get recommended care and make good lifestyle choices for better overall health and to stay well. Review this list to see if you’re up to date on your screenings, immunizations and recommendations.

Questions To Ask Your PCP

It can be overwhelming when you go to your PCP  for your wellness exam. Preparing questions ahead of time can help you get the answers you need.

Some questions you may want to ask your PCP include:

  • Am I at a healthy weight? Has my weight changed a lot since my last wellness exam?
  • Are my feelings of sadness, anxiety, or stress normal?
  • Are the supplements I’m taking worthwhile?
  • What should I be eating?
  • What's the best exercise plan for me?
  • How can I reduce or stop some of my medications?
  • What changes should I make in my lifestyle based on my age and habits?
  • Something doesn’t feel right – can I ask you about it?
  • What should I work on before my next visit?
  • What's the best way to communicate with you if I have questions? Do you text or use email? Are you the one answering these messages?

Know What to Expect During Your Annual Wellness Exam

Now that you've made your wellness exam appointment and thought of questions to ask your PCP, you may be wondering how your wellness exam will go.

During your exam, your PCP will likely:

  • Develop a plan to achieve your health goals 
  • Discuss your chronic conditions and coordination of care, if applicable
  • Perform a physical exam, including measuring your weight, height and blood pressure 
  • Recommend routine screenings, immunizations and other preventive care
  • Talk about your health history and lifestyle