The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

How can I find out if my doctor is in a health plan’s network?

Individuals with no coverage | Comparing Plans: Benefits and Costs |
ANSWER

Each plan sold in the Marketplace must provide a link on the Marketplace website to its health provider directory so consumers can find out if their health providers are included. Health plans are also required to keep their provider lists up to date. If your state uses HealthCare.gov, the Marketplace website has a doctor look-up tool so that consumers can determine whether or not a doctor is included in a health plan’s network. A similar feature may be available if your state operates its own Marketplace website. However, as an extra measure, you may want to call the plan directly as well as your provider to confirm that he or she is “in-network.”

The provider network information from insurance companies must also tell you whether a provider is accepting new patients. (45 C.F.R. § 156.230.)

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