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 update their provider lists at least once a month. A doctor look-up tool is available on HealthCare.gov so that consumers can determine whether or not a doctor is included in a health plan’s network. However, as an extra measure, you may want to call your provider to confirm that he or she is “in-network” if it matters to you or if the cost-sharing you’d be required to pay for “out-of-network” care is significant.

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

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