published to April 18, 2019
Before seeing a doctor, it’s important to understand the services and costs covered by your insurance plan. I have a few questions below.
Does my health insurance cover my current doctor?
- Call your doctor’s office directly and ask if they accept insurance. You can also check his website for health insurance and their provider directory.
- If you want, you can also ask about the plan before your visit. Without it, you may be billed for what your health insurance would have paid.
Does my health insurance cover the services I need?
- All private health insurance plans offered on the Marketplace offer the same set of prescription drugs, emergency services, pregnancy, maternity, and newborn care.
- Some plans may offer additional coverage. Please contact your plan if you have questions about whether a service is covered.
What will be the cost?
- With most health plans, you’ll get the best value if you see a doctor with whom you have an insurance policy (also known as an “in-network” provider). You may be able to see a doctor who isn’t part of your plan (called an “out-of-network” provider), but your out-of-pocket costs may be higher.
- Taking the time now to find out which services on your plan are not covered by your health insurance can help you avoid surprises before your appointment. Before, we charge only the copay for primary care visits. Some even offer discounts on medicines, including generics.