Avoiding Additional Charges when Seeking Care
February 7, 2020You may have signed up for a health insurance plan with a different carrier for this year, or you may be with the same insurance carrier but you need to see a specialist. These are reasons to know and understand your health insurance plan’s network.
Doctors who are in network have negotiated prices with the insurance company. This protects you as the insured, and protects the company as the insurer, from unexpected costs. When you have a copay or coinsurance, that amount is applied to the cost of the services AFTER the negotiated discount is applied to the bill. When you choose to see an out of network doctor, they send the full bill to your insurance provider. If they cover any of the bill, you are left with the remaining costs.
How do you find out if a doctor is in your plan’s network? First of all, if you do call a doctor’s office, you need to ask if they are IN NETWORK. If you call any doctor’s office and ask if they accept your insurance, they will all say yes. They will accept your card and bill your insurance company, no problem! However, asking if they are IN NETWORK lets you know if they have contracted rates with your insurance plan. You can also go online to your insurance carrier’s website to search for doctors. You can search by your zip code or by the doctor’s name. An easier way is to call the member services number on your insurance card and ask them to help you look up a doctor. That way you know if a doctor is IN NETWORK and accepts your plan.
If you are in an emergency situation and need to seek immediate care, you don’t need to worry about if the hospital is in network or not. All emergency care is considered in network. If you need to be admitted to the hospital, this is where you need to be transferred to an IN NETWORK hospital. If you remain at the hospital that isn’t in your network, you won’t receive the negotiated pricing on any care after the emergency room.
If you have any questions about your insurance plan and how to find IN NETWORK providers, give us a call or send us an email and we will help you!
Kenyon Petersen Insurance 801-610-9086 Kpetersen@insurewithcompass.com