Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan (also called an “in-network” provider). While you may be able to see doctors who don’t contract with your plan (called “out-of-network” providers), you’ll pay higher out-of-pocket costs for those doctors.
To find out if your doctor and other health care providers work with your health plan, or to find providers who work with your plan: visit your health plan’s website and check their provider directory, call your insurer to ask about specific providers, or call your doctor’s office directly. They can tell you if they accept your health plan.
Your insurance company must notify you in writing within a set amount of time to explain why coverage was denied. They also have to let you know how you can appeal their decisions. If you go to your regular doctor and find out later that your new plan doesn’t cover them and they don’t pay for that visit to the doctor, you have the right to appeal the decision and have it reviewed by an independent third party. Review the materials provided to you by your health plan to learn more about the appeals process.
HealthTN takes pride in assisting beneficiaries in navigating their health care needs. While the core reason many purchase insurance has not changed, the process has. Our agents are trained in multiple plans to help you find the health insurance that best fits you! Visit HealthTN.com today.