I found out the hard way that my doctor was not in network.
It is a normal occurrence for me. Every winter I catch a cold, and every winter I want to beat the cold. Normally, stick to my usual plan, and I diligently combat my cold with Emergen-C, cough drops, and I use a Neti-Pot twice a day. If I stay true to the routine, I always beat the cold.
This year was different. I tried the same routine, and nothing was working. At this point, I decided to give in and go see my family doctor. My boss gave me the green light, so I left work early, and drove across town in the late afternoon. I walked into the office, I pulled out my insurance card, and the receptionist eyed the card for a few seconds. She then said, “we don’t accept this insurance.”
My Doctor Wasn’t In Network
At first I was shocked because I had Blue Cross Blue Shield of Tennessee health insurance, and in my experience, every provider in the Chattanooga area accepts Blue Cross Blue Shield. Naturally, my next comment was, “but my insurance is Blue Cross. I thought Dr._____ accepts this insurance.” She said that my family doctor is not in network for Blue Cross Network E.
I had been helping clients buy insurance for months at this point, and I know the difference between the Blue Cross Blue Shield networks in the State of Tennessee. The largest distinction between the BCBS’ networks is that providers are more likely to accept Networks S and P over Network E. I could not believe that I did not do my due diligence to find out if my own primary care physician accepted my insurance.
Make Sure Your Doctor is In Network
It is easy to find out if your doctor is in network. Insurance agents have easy access to directories listing the participating providers in your area. Health insurance companies readily publish a list of doctors who participate in their various health insurance networks. It only takes an agent a few seconds to verify that your family doctor is in network.
I cannot speak for all health insurance agents, but health insurance agents should want you to be able to enjoy the benefits of a plan he or she sold you. Using your health insurance to see your family doctor is a primary concern in buying health insurance. A health insurance agent should ask you for your doctor’s name up front. If not, ask your insurance agent to see if your doctor is in network.
Don’t arrive at your doctor’s office to find that the doctor does not accept your new health insurance!
How will I know if my doctor is in network?
Most health insurance companies want consumers to know which providers participate in their networks. For example, Blue Cross Blue Shield of Tennessee sells the most Marketplace health insurance plans in Tennessee.
Those who buy Marketplace–also known as Obamacare–plans can go to Blue Cross’ and website click on the “Find a Doctor” icon prominently displayed on the right or click here. Selecting a network and searching for providers is easy moving forward.
This is just one example of how health insurance companies connect consumers to providers in the State of Tennessee. Other health insurance companies in other states have easy-to-use provider look up tools–as your agent how to find them!
Of course, or agents are standing by to help you find out if your doctor is in-network. We can walk you through the other benefits of health plans as well. Give us a shout at either 1-888-995-1674 or at 423-424-0586* for help with your health insurance!
Philip Strang is a health insurance agent at American Exchange. He focuses on helping individuals and families with their health insurance.
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