You’ve already elected a plan for 2017—but you’re not covered yet. Understanding the cost of visiting a doctor out-of-network will save you thousands of dollars this year. Avoid the unnecessary stress of filing claims and know what doctors are participating in your network.
Start with the Network
Most health insurance plans are going to have a group of physicians and hospitals that they are contracted with. Typically doctors are affiliated with a specific hospital. For those of us who have a hospital preference, pin pointing these hospital affiliations is a good way to narrow down your search. The best way to prevent having unexpected health care costs is to check which doctors are covered in your plan’s network. Carriers will cover a larger percentage of the costs when visiting a physician or hospital that is in-network, and will cover much less (sometimes nothing) if the doctor is out-of-network.
Note: Visiting an in-network hospital or other medical facility does not guarantee every practicing physician within that facility is contracted with your plan. It’s always good to get a second opinion in medicine, and it’s always good to double check who is in-network and who is not.
Contact your Doctor’s Office
It’s always good to get a second opinion. Call your doctor and ask for the office manager—they have access to the updated list of insurance plans your doctor is accepting this year. When looking for a new doctor they are also the ones who can tell you if that doctor is accepting new patients. Deciding on a doctor can seem like a daunting decision. Remember, you’re never locked in. Patients change doctors every day and that’s okay.
Many people go out of network by accident.
For example: Your Primary Care Physician might refer you to an out-of-network specialist. Unless this is the only specialist who can treat you, kindly ask your PCP to refer you to in-network specialist only.
Rather than relying on a broad search engine or crossing your fingers. Allow us to point you in the right direction.
Step by Step Guide to help you search for In-Network Doctors and Specialists
United Healthcare networks:
- Core
- Choice Plus (PPO)
- Largest network in the nation
- Navigate (HMO)
Provider search instructions:
- Visit www.myuhc.com
- Under “Links and Tools” (top right of page) select “Find Physician, Laboratory or Facility”
- Choose a type of plan—select “All UnitedHealthcare Plans”
- To find the plan you are looking for, check the bottom right corner of your member ID card
- Enter your zip code for closest proximity or city and state of your choice (you can search as close as 1 mile and as far as 100 miles away from your zip code—depending how far you are willing to travel)
- If you know the name of the doctor you’re looking for—great. If not start by selecting a category: Primary Care Physician, Generalist, Internist
- Filter further by ranking, alphabetical order or price range
Blue Cross Blue Shield of Illinois networks:
- Blue Choice Preferred
- Preferred Provider Organization (PPO)
- Blue Precision (HMO)
Provider search instructions:
- Visit www.bcbsil.com
- Click “Find a Doctor” (top right of page)
- Click “Start Search” (orange button)
- “Select from the list below” and choose your desired network
- To locate hospitals close to home—first enter you zip code then select Provider Type to “Hospital or other Facility” and Provider Specialty as “General Acute Care Hospital”
- To locate a specific doctor—enter your doctors name, zip and “Results Within”. If you do not have a specific doctor, leave that section blank and search doctors within the designated city or zip
