Health Insurance Blog

Is My Doctor in My Health Insurance Network?

Posted by:
Tim Jackson
on
July 7, 2014
Of course no one likes getting a ridiculously large bill from their doctor. Especially when this bill was unexpected. Here are a couple things...

Of course no one likes getting a ridiculously large bill from their doctor.  Especially when this bill was unexpected.  

Here are a couple things that can help you avoid this situation:

Make sure your provider is “In Network” and that they are a “Preferred Provider” for your specific insurance plans.  Lots of Doctors accept the insurance carrier without being in your network, so it is important to verify this information prior to scheduling an appointment. This can be a tricky process, so it’s definitely worth taking time to do properly.

Even when the doctor you would like to see mentions that they accept the insurance carrier whom your plan is through, you may not be covered.  Not really, at least.  For example, I searched for a family practice physician in our area that had been referred to me by another doctor.  Our insurance carrier was listed in the accepted insurance carriers on the physician’s webpage.  When I called our insurance carrier to verify coverage, I learned that because of our specific plan, we would still be responsible of most of the cost of each visit that was not considered “preventative care”.  Because of this information, we chose to go with a different provider who was preferred for our plan.  This way, we will be paying co-pays as usual but still be able to be seen for all of our medical needs without having to pay what we would have been responsible for with an out of network or non-preferred provider.

You can simply get in touch with your insurance carrier to verify specific coverage and benefits.  This way, you will have a better idea about what you will be paying for healthcare.

This article was written by Marissa, a contributing writer and employee of The Health Insurance Specialists, Inc.

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