Finding Care After Your Doctor Leaves Your Health Plan
If you have been fortunate enough to find a primary or specialty care doctor you love, it can be disappointing to say the least, when your doctor will no longer accept your health insurance plan. This means you’ll have to pay out of your own pocket to receive care from that point going forward. If you find out that your doctor is no longer within your insurance network, it can cause stress, anger and fear. You do, however, have several options on what you can do.
What to Do If Your Doctor Goes Insurance-Free
Doctors go insurance-free for several reasons, such as decreased reimbursement rates from health insurance companies, and excessive paperwork. In many cases, doctors who do not accept insurance have flat rates, or income-based sliding fee schedules, to keep care affordable. Other providers have monthly, quarterly, or annual fees, where their patients pay in advance, in exchange for a certain number of services or visits. Some may require payment at the time service is rendered each visit.
If your doctor goes insurance-free, talk to the billing office to determine how much care will cost. In some cases, it may not be much more than you would pay with health insurance coverage. Caution here, you may mistakenly feel that insurance is no longer important or necessary. Nothing could be further from the truth! The true cost of health care totally out of your own pocket could devastate you financially. Tests, lab work, prescription coverage, and hospitalization or emergency care can be thousands of dollars. In all cases, if you are determined to stay with your doctor no matter what, until you have a new “enrollment period” so you can switch health insurance options, it is best to pay your doctor, sometimes referred to “cash pay” and keep your insurance for all other necessary reasons. One unforeseen emergency without insurance is why you’ll want to keep insurance. One bout of cancer, an embolism, a heart attack, a strange infection, an accident, so many things that could happen that your 1 specific doctor cannot take care of is why you’d want to keep that insurance in place.
What to Do If Your Doctor Rejects Your Health Insurance
If your doctor rejects your health insurance plan, it is a good idea to call the health insurance company and state your case. In some cases, your health insurance provider may honor your appeal. Obviously, this does not happen often, but if your provider is providing a service that no one in your city/county provides, your insurance company may make exceptions for you to continue seeing your provider. You can also ask if your doctor’s office will submit an out-of-network claim on your behalf or provide you with necessary paperwork to file it yourself. You may also inquire about what you would pay out-of-pocket as a cash pay client.
New Insurance Plan? – Find Out If You Are Protected in Nevada
If you find yourself losing your health insurance plan and your new plan does not have your doctor in their network, now what do you do? There are some cases in which you are entitled to continue receiving care from your current medical provider, even if they are no longer within your plan’s network.
In Nevada, if you are actively undergoing medically necessary treatment, many insurance companies will work with their new members on transition of care. Depending on the patient’s need, there are times the insurance company may negotiate with the existing provider to complete their care.
How to Find a New Doctor
- Get recommendations from friends
- Ask for a recommendation or referral from your doctor
- Familiarize yourself with your health insurance plan’s in-network provider list
- Ask your agent for a copy of, or where to look online for the “provider directory”
- Get yourself a great Broker – call Nevada Insurance Enrollment 702-898-0554
- Finding a new doctor may feel intimidating, but there are several steps you can take to make the process as hassle-free as possible.
Understanding Your Health Insurance Coverage with Nevada Insurance Enrollment
At Nevada Insurance Enrollment, health insurance agents can help you find your plan’s list of in-network providers and understand your coverage for primary and specialty care. If you do not currently have health insurance coverage, we can also help you find a plan that your preferred health care provider accepts.
Recent Posts
HRA vs Employer Sponsored Health Insurance
An employer-subsidized plan is a sensible option for employees. Not only does the employer pay at least 50% of the employee’s premium, but the remaining premium is tax-free and taken directly from the employee’s pay.
Can You Choose Between Medicaid or Obamacare for Health Insurance?
The good news is that even those with very limited incomes can get low-cost health insurance or even free medical coverage through the Affordable Care Act’s Marketplace health insurance plans, often referred to as Obamacare, or through Nevada Medicaid.
Saving Money on Health Insurance With Negotiated Pricing
The majority of health insurance companies have a contract with a network of hospitals and other providers. In this contract, there are negotiated rates for different services. This negotiated rate is generally lower and sometimes significantly lower than what a provider would charge someone who is paying out of pocket.
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Health Insurance with a Preexisting Condition
You may assume that since you have a preexisting condition, you’ll pay a higher premium than someone who is in perfect health. However, an insurer cannot reject you, refuse to pay for health benefits pertaining to your illness or injury, or charge you a higher premium because of your condition.
Is Physical Therapy Covered Under Health Insurance?
Whether you have recently been injured or you are experiencing chronic pain or limited mobility, going to a physical therapist can greatly improve your quality of life. For many people, concerns about how much regular sessions cost is a big roadblock to getting much needed care. Fortunately, if you have an ACA-compliant health insurance plan, rehabilitative services like physical therapy are listed among the essential health benefits.
What Is a Health Insurance Network?
Whether you’ve had the same health insurance company for years or switched to a new health insurance company, the variance in cost is directly related to whether a healthcare provider is within your health insurance company’s network (if you have a PPO), if you have a deductible to satisfy first, or if you have a co-pay.
What is a Special Enrollment Period?
The special enrollment period is always within 60 days of a life event. A “Life Event” is an event such as the birth of a baby, losing group coverage through an employer, losing coverage due to a move to Nevada, marriage, any many other scenarios.