In Australia, you probably just rocked up to whatever GP was available, got seen in 20 minutes, and went about your day. Maybe you had a regular doctor, maybe you didn't—it didn't really matter because the system just worked and was wholly or partially covered by Medicare. Unfortunately it's not the same in the US and ensuring you know the difference between PCPs and other doctors will ensure your bills don't get too high.
The US is different. Very different. Here, you need to find a primary care doctor before you get sick. You need to make sure they're “in-network” with your insurance. You'll probably wait weeks for an appointment. And if you need to see a specialist? You might need a referral from your primary care doctor first.
It's a lot. But once you understand how it works, it's manageable. Here's everything you need to know.
What Is a Primary Care Doctor (And Why Can't I Just Go to Urgent Care)?
A primary care doctor—also called a PCP, primary care physician, or primary care provider—is your main doctor for general health. Think of them as your home base in the US healthcare system.
They handle:
- Annual checkups and physicals
- General illness (colds, infections, minor injuries)
- Ongoing conditions (high blood pressure, diabetes, mental health)
- Preventive care (vaccinations, screenings)
- Referrals to specialists
Why can't you just skip this and go to urgent care when you're sick?
You can, technically. But there are a few problems:
- Urgent care is more expensive (higher copay, usually $50–$75 vs. $20–$30 for a PCP visit)
- They don't know your medical history
- They can't manage ongoing issues or prescriptions
- They often can't refer you to specialists
- Some insurance plans require you to have a PCP on file
The US system is built around having a primary care doctor as your first point of contact. Fighting this will cost you time and money.
Step 1: Check Your Insurance Network
Before you do anything else, you need to understand your insurance network. This is the most important thing in US healthcare and it trips up almost every Australian.
In-network means the doctor has a contract with your insurance company. You pay less.
Out-of-network means they don't. You pay significantly more—sometimes the full cost.
The difference can be huge. An in-network PCP visit might cost you a $25 copay. The same visit out-of-network could cost you $200+ out of pocket.
How to check:
- Log into your insurance company's website or app
- Look for “Find a Doctor” or “Provider Directory”
- Filter by “Primary Care,” “Internal Medicine,” or “Family Medicine”
- Enter your zip code
Common insurance portals include companies like:
- Aetna: aetna.com
- UnitedHealthcare: uhc.com
- Cigna: cigna.com
- Blue Cross Blue Shield: bcbs.com (varies by state)
- Oscar: hioscar.com
- Empire: empireblue.com
Pro tip: Even if a doctor shows up as in-network online, call their office and confirm they accept your specific plan. Networks change, and directories aren't always current.
Step 2: Understand the Types of Primary Care Doctors
You'll see a few different titles when searching. Here's what they mean:
Family Medicine (Family Practice)
- Treats all ages, from babies to elderly
- Good if you have kids or want one doctor for the whole family
- Broad generalist
Internal Medicine (Internist)
- Treats adults only (18+)
- Often more focused on complex or chronic conditions
- Common choice for adults without kids
General Practice
- Similar to family medicine, treats all ages
- Less common term these days
For most Australian expats without kids, an internist is a solid choice. If you have a family, family medicine makes more sense.
You might also see:
- DO vs. MD: Both are fully licensed doctors. DOs (Doctor of Osteopathic Medicine) have additional training in musculoskeletal manipulation, but for primary care purposes, they're equivalent.
- NP or PA: Nurse Practitioners and Physician Assistants can also serve as your primary care provider. They're fully qualified for routine care and often easier to get appointments with.
Step 3: Actually Find a Doctor
Once you know your network, here's how to find someone good:
Option 1: Your insurance portal (from above): Start here. Filter by location, specialty, and whether they're accepting new patients. The results won't tell you if the doctor is good, but at least they'll be covered.
Option 2: ZocDoc (zocdoc.com) This is like OpenTable for doctors. You can:
- See real patient reviews
- Filter by insurance accepted
- Book appointments online
- See available time slots
ZocDoc is especially useful in cities like NYC and I highly recommend it. It has become the de facto standard for all medical professionals.
Option 3: Ask your community Post in expat groups (like the America Josh Facebook group!) and ask for recommendations. Other Australians will tell you who actually listens, who rushes you out, and who's worth the wait. This one-on-one recommendation is important and you should be as specific about your needs and location as you are comfortable sharing. The double-edged difficulty is that there are so many doctors, you need to comb through the options thoroughly and find one who is available (see below)
Option 4: Your employer If your company has an HR team or benefits coordinator, they might have recommendations or even an on-site clinic.
Step 4: Check If They're Accepting New Patients
This is a frustrating reality in the US: many good doctors have full panels and aren't taking new patients. When you find someone promising, call the office and ask:
“Hi, I'm looking for a new primary care doctor. Is Dr. [Name] accepting new patients with [Your Insurance Plan]?”
If they're not, ask if there's a waitlist or if another doctor in the same practice is available.
Step 5: Book Your First Appointment
Once you've found a doctor accepting new patients, book a “new patient appointment” or “establish care visit.” This first appointment is longer than usual (often 30–45 minutes) and covers:
- Your full medical history
- Current medications
- Family medical history
- Any current concerns
- Baseline vitals and possibly bloodwork
What to bring:
- Insurance card
- Photo ID
- List of current medications (names and dosages)
- Any medical records you have from Australia (or request them ahead of time)
- List of questions or concerns
Expect paperwork. You'll fill out forms about your history, allergies, emergency contacts, and privacy consent (HIPAA). Some offices let you do this online beforehand online or through app portals.
Step 6: Understand How Visits Work Going Forward
After you've established care, here's how it typically works:
Annual physical / wellness visit Most insurance plans cover one free preventive visit per year. This includes basic checkups, screenings, and vaccinations. It's fully covered with no copay—but only if it stays “preventive.” If you bring up a specific problem (like a sore knee), it might become a “sick visit” with a copay.
Yes, this might feel absurd going to the doctor before you're sick but that's how it works. Some people book separate appointments for their annual physical and any specific issues.
Sick visits When you're unwell, you call and book a sick visit. Depending on the practice, you might get in same-day or within a few days. If it's urgent and they can't see you, they'll direct you to urgent care.
Referrals Need to see a dermatologist? Cardiologist? Orthopedic surgeon? Depending on your insurance plan (especially HMOs), you may need a referral from your PCP first. Your PCP writes the referral, and then you can book with the specialist.
PPO plans are more flexible and often let you self-refer, but it's still worth checking.
What If You Can't Get an Appointment for Weeks?
Welcome to American healthcare. Here are your options:
Telehealth Many PCPs offer video visits for minor issues. Your insurance might also include telehealth services like Teladoc or MDLive. It's not ideal for everything, but great for quick consultations, prescription refills, or advice on whether you need to be seen in person.
Urgent care For issues that can't wait but aren't emergencies (infections, minor injuries, flu), urgent care is your backup. CityMD, GoHealth, and CVS MinuteClinic are common chains. Expect a $50–$75 copay and a wait, but no appointment needed and you'll have to sit in a waiting room for a while (bring a mask.)
Emergency room Only for true emergencies—chest pain, severe bleeding, difficulty breathing, serious injuries. ER visits are extremely expensive (often $500+ even with insurance) and can take hours. Do not do this unless you have critical issues as it's going to be a day at least of hurry up and wait.
Nurse hotlines Many insurance plans have 24/7 nurse hotlines where you can describe symptoms and get advice on what level of care you need. Check your insurance card or app.
The Australian Mindset Adjustment
A few things that take getting used to:
You can't just walk in. Almost everything is by appointment. Even urgent care has wait times.
You need to advocate for yourself. Doctors are often rushed. Come prepared with questions and don't leave until you understand your diagnosis and next steps.
Costs aren't transparent. You often won't know what something costs until after you receive a bill. Ask upfront: “Is this covered by my insurance? What will my out-of-pocket cost be?” These questions are expected from everyone, not just you.
Bills come later. You might get a bill weeks or months after a visit. This is normal (and annoying). Review your Explanation of Benefits (EOB) from your insurance to understand what was covered. Question everything, and ensure they give you a proper reason for what was billed.
It's okay to switch. If you don't like your doctor, find another one. You're not locked in.
Quick Reference: PCP vs. Urgent Care vs. ER
| Situation | Where to Go |
|---|---|
| Annual checkup, preventive care | PCP |
| Cold, flu, minor infection | PCP (or urgent care if no appointment) |
| Prescription refill | PCP (or telehealth) |
| Minor injury, sprain | Urgent care |
| UTI, ear infection, pink eye | Urgent care (or PCP if available) |
| Chest pain, difficulty breathing | ER (call 911) |
| Severe injury, heavy bleeding | ER (call 911) |
| Mental health crisis | ER or 988 Suicide & Crisis Lifeline |
Finding a primary care doctor in the US takes more effort than it ever did in Australia. But once you have one, everything else gets easier—referrals, prescriptions, ongoing care, even just having someone who knows your history.
Don't wait until you're sick. Find a PCP now, book that first appointment, and get established. Future you will thank you.
