Behind every insurance card is a benefit plan with varying deductibles, co-pays, coverage limitations, and exclusions. Cost is a major factor when you select an insurance plan, but you can’t take it as a given that your doctor will be in network with every plan. Here are 3 things you can do now to keep from losing your preferred physician.
- Talk to HR – If you get your health insurance through your work, this is the time of year when most employers are selecting next year’s plan. Many employers will take employee preferences for doctors into account when selecting an insurance carrier, especially if a lot of their employees prefer doctors that are not in the network they are leaning toward. Contact your Human Resources department to let them know the doctors you’d prefer to keep in network.
- Call your insurance carrier – If insurers hear from customers that they are missing physicians in their network, they are more likely to attempt to bring those physicians into that network, so let them hear from you! To reach them, simply call the customer service line on the back of your insurance card.
- Call the Big Boss – In Texas, the Texas Department of Insurance (TDI) regulates the insurance industry and it was put in place to protect YOU! If you feel your health plan does not have an adequate network, you can submit an online complaint form to TDI. It’s simple to complete and TDI will assign someone to help you resolve your complaint.
If all else fails and you end up in a network your doctor isn’t part of, talk with your doctor’s office about being seen as a “cash pay” patient. This doesn’t actually mean you have to pay with cash, just that you will be billed without going through your insurance. Many doctors offer significant discounts for patients who are seen as “cash pay” and, if your insurance deductible is very high, you may end up paying less than you would to see an in network doctor!