Make sure you use doctors and service providers that are in-network:
- It will significantly reduce your out-of-pocket medical expenses, and
- Ensure any costs you incur are applied towards your plan's deductible and out-of-pocket maximum (out-of-network costs don't count).
Ask "Is this in my network?"
When making an appointment or scheduling a procedure, the most common question patients ask is "Do you take my insurance?" While many doctors and hospitals will accept your insurance, it doesn't mean they are in your network. And going out-of-network is expensive.
Instead, ask "Is this in my network?" And, if you're in the ER or hospital, be sure to write "only use in-network care" on all paperwork you sign.
As the insurance policy holder, it's your responsibility to make sure you only use in-network providers and facilities. So you should always verify in-network coverage.
Did you know...? An insurance carrier's list of in-network providers isn't reflected in real time—the latest results may be a couple days out of sync due to processing changes.
What if my doctor/provider isn't covered?
For many, determining whether your primary care physician and health care providers are in-network is a key factor in selecting a plan. Ideally, your preferred doctor and preferred health plan line up.
Sometimes a tough decision has to be made: Do I go with my preferred plan (and find a new doctor) or select a more expensive plan that covers my doctor?
Only you can determine what will best serve you and your family in this situation. Are you financially able to take on higher costs? Will there be discontinuity in care?