You’ll want to look up the doctor or specialist in your insurance provider’s network directory to verify that they are part of your plan. Most insurance companies have online portals, even mobile applications, which help one search for health providers by name, specialty, or location. This is a list of every doctor, specialist, hospital, or any other health facility that is in-network because it has agreed to the insurance company’s pre-negotiated rates for healthcare procedures. Looking up the provider network tool should give one an easy and sure way to check on a certain provider being covered under your plan.
You can also call your insurance carrier’s customer service directly to speak with someone or check further. Just provide the name and location of your desired doctor or specialist, and they will be able to confirm for you if the provider is part of their network. You can also ask about the particulars of coverage, like co-pays or co-insurance rates, or if a referral is required to see a specialist. This, in particular, will make a huge difference if you have insurance with a plan that has multiple tiers or networks whereby the level of coverage may vary because of the status of the network for each provider.
You can contact your doctor’s office directly and get the information from them. Even if it is stated that the provider is in-network on an insurance company’s website, it’s always good to call their office to confirm they actually take your particular insurance plan. Insurance networks change, and sometimes this information doesn’t get updated online. You can avoid those kinds of surprises by checking up front with the provider’s office that the visit will be covered under your plan’s in-network rate. This becomes more important if you are going to see a specialist; out-of-network care is more expensive.
