It’s that time: you are considering a new health plan or choosing between several plans. But with a new plan, will you still be able to see your doctor, or will you need to find someone new? Before signing up for a new health plan, check to see if your preferred doctors, clinics and hospitals are covered.
“What is a provider network?”
Each health plan contracts with specific health care providers and facilities. This is called a “provider network” and it varies from plan to plan. Even two plans offered by the same insurance company can have different provider networks. For the lowest costs, make sure you are going to an in-network provider or hospital for your care. Depending on the type of plan, out-of-network providers and hospitals could be MUCH more expensive.
“I want to keep my doctor.”
If you already have doctors you like, check to see if they are in the plan’s provider network. The provider directories are usually on an insurance company’s web site. But the lists could be out of date. If you don’t see your doctor in the directory, call your doctor and ask if they are covered under that plan. If you have a preferred hospital, check to make sure it is in-network as well.
“I need to choose a new doctor.”
Maybe you don’t have a preferred provider or hospital. Or maybe your plan options do not cover your preferred doctor. First, try selecting a plan with many in-network providers close to your office or home. You can then use the Community Checkup to compare the quality of care different clinics provide.