The Specialist I Need Is Not On My Insurance Plan's List of Doctors

Remember that insurance plans in the marketplace must sign up enough doctors, hospitals, pharmacies, and other providers to make sure patients can get medical care. (See Who will take care of me? What are the networks?

When you don’t have a choice and your plan’s network doesn’t include the type of specialist you need, you can see a doctor that’s not on your plan. But your health plan can’t charge you more than you would pay if that doctor actually was on your current insurance plan.

The same thing applies if you have to get emergency care out of network. If it’s not an emergency, be sure to call your insurance company ahead of time to arrange to see an out-of-network specialist.  


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