There are a variety of health insurance options out there, and since different plans cover expenses in different ways, it is important to gather all the information before your doctor’s appointment.
Information you will need includes:
- What insurance company you are using
- What type of plan you have
- The exact name of your insurance plan
- The name of your doctor, or the doctor you wish to see
- Whether or not you purchased your insurance from the market place or have government-subsidized
This becomes more complicated when the same insurance company offers different plans that cover different doctors, and sometimes even specific locations that a doctor works from but not the other. As some insurance will not cover out of network visits at all, and others will only pay partial, it is important to know what type of plan and network you are insured under.
One of the easiest ways to find out for sure is to call the doctors office with the above information and ask them. The doctor office will be able to tell you if they are covered by your insurance and if they require a referral.
If that option is not ideal, you can go to the website for your insurance company and use the find a doctor feature. This allows you to search the doctors in the network to find yours or to pick a new one. You will need to know your plan information as not all plans with the same company will cover the same things.
The last way is to simply call the customer service number for your insurance provider and ask. You can provide them with the name of your plan, your name, and the name of your doctor or the type of doctor and treatment you are seeking. The customer service representative will have a full list of which doctors and locations are covered, and if you will need a referral. They can also explain what it is likely to cost if you need to use a doctor who is not in the network, which a doctors office may not be able to do.
In the world of health care and insurance, some things can be more complicated than expected. Sometimes the easiest way around that is to pick up the phone and ask someone who knows. Finding out if your doctor is in network or not is one of those times, asking the insurance provider or the doctors office directly. Be certain to have all your information first.