Most of my doctors are in-network but not all. Can I get care out-of-network?

Individuals with no coverage | Comparing Plans: Benefits and Costs

If you see a provider that is not included in your plan’s contracted network of providers (i.e., “out-of-network”), depending on your plan that care may or may not be covered. Either way, you are likely to pay more for out-of-network services. Also, the Affordable Care Act's limit on your annual out-of-pocket costs applies only to services received in-network. Any care you get outside your plan’s network will not apply to the limit set in law (in 2023, $9,100 for individuals, $18,200 for families) and may not have any limit at all. (FAQs About Affordable Care Act Implementation Part 46, June 4, 2021; CCIIO, Premium Adjustment Percentage, Maximum Annual Limitation on Cost Sharing, Reduced Maximum Annual Limitation on Cost Sharing, and Required Contribution Percentage for the 2023 Benefit Year).

Related Tags

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues