Most people have at least two doctors. There is always the family doctor or general physician. Then, there is the specialist. Maybe you have a dermatologist, or maybe you have an allergist. Maybe it is a cardiologist, or a pulmonologist. Whatever the specialist, is he/she part of your insurance network, or do you pay out-of-pocket to see him/her? Wait, you do not know what your insurance network is? Well, then, here is a little extra info to put your medical needs and doctors in perspective.
What an Insurance Network Is
At first mention, it sounds like an insurance network is lots of insurance companies networking and working together. In fact, an insurance network is a single company that connects hundreds to thousands of doctors and medical professionals together under one medical group and one medical group name. For example, Affinity Insurance Group covers all Affinity hospitals and clinics. It may temporarily partner with other networks when other networks do not have specific specialists working for them, and patients need a particular specialist.
Conversely, if a network is in need of a particular specialist it does not have, it can form a partnership with another network to provide the services of said specialist for the needs of a patient. The first insurance network covers the cost of care by the medical professional outside of the network.
Finding out If All of Your Doctors Are "in Network"
Typically, your family doctor or general physician is always "in-network." It is your specialists that might not be. If you want to know which of your specialists (if applicable) are in- or out-of-network, you can actually call your health insurance provider and request a network catalog. This thick book lists every last doctor, dentist, specialist, surgeon, and vision care specialist that are in your insurance network. If you do not see your other doctor(s) listed, you can call the toll-free number on or inside this booklet and speak to an insurance representative. He/she has a much more up-to-date record of which doctors are in the network, versus the ones that are working with your insurance on your behalf outside of the network.
Additionally, it helps to keep this booklet around for future reference. If you ever need a physical therapist, a dietitian or any other kind of health care provider, you can look it up in the booklet. Then ask your family doctor for a referral to that specialist.Share