How Do I Find Out If a Doctor Is Covered By My Insurance?

One of the common questions that people have about their health insurance is whether they can use a specific doctor. When signing up for health insurance for the first time, or the first time with a new plan, most people are mostly concerned about keeping the same doctor that they have always had – either through a different insurance plan or on a cash basis. In this article, we will be covering how you can find out whether your doctor is covered on your new insurance plan and some steps that you can take if you find that your regular doctor is not part of your new health insurance network.

Check with Your Doctor

doctor covered by insuranceBy and far, the easiest method for finding out whether your doctors part of your current health insurance network is by asking. By asking your doctor or his or her nursing staff, you can cut straight through any of the searching that you might have to do otherwise and get a definite answer. If your insurance plan is a common one, then they will probably know right off the top of their head. If not, then they may have the resources to look up the health insurance plans that they accept and find out if yours is on the list.

In some rare cases, your doctor and his or her staff will not know whether your health insurance is covered area this may be because they have incomplete records on the health insurance plans that they accept, or it may be because while they are willing to accept the insurance, the health insurance company has determined that they are not eligible to be part of that network. Some networks are restrictive on the number of doctors in a specific geographical region or the number of specialists so your doctor may not know for sure if your insurance company will pay.

Check Your Health Insurance Website

You should also check with your health insurance website and find out what they say about which doctors are part of your network. Usually, if your health insurance plan is a regional one, then they will have a list of all of the doctors and providers in the area that are covered under their network. You can look at your specific city and find your doctor’s office or doctor’s name to make sure that the insurance company will pay them if you go to them for primary care. You also have to do the same thing with any specialists.

Of course, you don’t want to rely up on a list that your health care network maintains or entries on their website. While these are accurate most of the time, they do get updated regularly, with some doctors getting removed from the network while others get added. You may want to call them directly and ask just to make sure.

Most people are worried about switching doctors, but one thing that you may want to consider is that your doctor may be able to refer you to someone within your network that you will like just as much as them. Physicians often make referrals of this type, and your doctor likely knows several other doctors in town that will treat you well.

Other Options You Should be Aware of

There are some additional options that you should be aware of. First, you may be able to convince your doctor to accept your new health insurance. If it is your doctor that does not currently accept your health insurance instead of the other way around, then a simple request might allow you to keep both your insurance and your same doctor. You also may be able to switch to a similar insurance plan that will allow you to keep your doctor and give you nearly the same options that you had with your health plan. You should consider every possibility when it comes to getting the right healthcare planning getting the right doctor, because the wrong ones can make it more difficult for you to manage your healthcare.

The Bottom Line

The bottom line is that there are several different options when it comes to figuring out how to choose the doctor that is it within your network or figuring out whether your current doctor is within the network of your current insurance. Many times you can ask your doctor if they accept your insurance, but you have to check with the insurance company as well and make sure that they are willing to partner with your doctor and pay your medical bills when they come due. If you cannot reconcile the two, then you may have to explore additional options including getting a referral to a new doctor or changing your healthcare plan.

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