It’s difficult enough to plan for medical expense, let only surprise expenses! Understanding your medical plan and what’s available in your network is crucial to save you from unnecessary costs and stress.
Just because a hospital participates in the health plan’s network does not mean all the health care professionals a patient will interact with at the hospital are also in network. Here are some tips to help you avoid those surprise costs:
- Ask what providers are in your network.
- Ask how your health plan covers care from a provider who is not in network.
- When you need to get a service, check again with both your provider and the health plan to make sure that the provider is in the network.
- If you need to see a specialist health care professional, also check to make sure that the specialist is in the network. Sometimes your primary care provider will recommend that you see a physician specialist or other health care professional. once you have a referral to a specialist, confirm with that specialist that they are in network when you make your appointment.
- if you need to have a procedure, ask where it will take place.
- ask who else might be involved in your procedure. In addition to the doctor you have chosen for your procedure, there are often other health care professionals who are involved in a medical procedure. for example, an anesthesiologist may give you medicine that helps you sleep through the procedure. You can get this information from your doctor, the hospital or other facility where your procedure will take place, or your health plan.
- Give yourself plenty of time. Most health care services and procedures are scheduled in advance. take advantage of this time to get answers to any questions about whether your health care providers are in network.
- Write down all the information you receive to check for accuracy before and after a service takes place.
- If you think you received an incorrect medical bill, or question the amount of the bill, seek help.
Additional resources below available from AHIP, and HFMA, in Spanish and English
Consumer Guide
