QUESTION

I’m no longer eligible for Medicaid and need to switch to a Marketplace plan. Will I still have access to the same doctors and medications?

Transitions from Medicaid to Private Insurance | Transitions from Medicaid to Private Insurance |
ANSWER

Not necessarily. The plans on the Marketplace could have different provider networks and benefits than what you are used to. Before you select a plan, it is important to check the plan’s provider directory and confirm that your doctor and other providers that you wish to retain are included in the plan’s network. And, because many provider directories are inaccurate or out-of-date, you should also call your provider(s) and ask them to confirm that they are in the plan’s network.

Similarly, if you want to ensure that you can continue with a particular medication or medications, you should check the formulary of the Marketplace plan before you enroll, to ensure that your medication(s) are included.

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