Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan. While you may be able to see doctors who don’t contract with your plan, visiting an “in-network” provider usually means you’ll have lower out-of-pocket costs.
Finding a doctor in your plan
To find out if your doctors and other health care providers are covered by your new Marketplace plan, or to find a covered provider if you don’t have one yet:
- Visit your health plan’s website and check their provider directory, which is a list of the doctors, hospitals, and other health care providers that your plan contracts with to provide care.
- See your health plan’s provider directory. You can get this by contacting your plan, visiting the plan’s website, or using a link that you’ll find on the plan description in your Marketplace account.
- Call your insurer to ask about specific providers. This number is on your insurance card and the insurer’s website.
- Call your doctor’s office. They can tell you if they accept your health plan.
- Call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). A trained representative can help you find your insurer’s number
Is there an appeals process if I go to my regular doctor and find out later that my new plan doesn’t cover them?
Yes. If your health insurance company doesn’t pay for a visit to the doctor, you have the right to appeal the decision and have it reviewed by an independent third party. Learn about the appeals process.