QUESTION

My doctor’s office is located in a neighboring state. Will I still be able to see him if I get a plan on the Marketplace?

Individuals with no coverage | Health Insurance Marketplace: Navigating New Coverage Options
ANSWER

It will depend on whether or not the health plan you choose covers your doctor. Some plans may offer a broader scope of covered providers than others. To make sure your doctor is covered under a plan, you should call the plan and ask. Note that it is important to ask the provider not just about the insurance company offering the plan, but whether he or she participates in the network of the specific plan the insurance company is offering. However, before selecting a new plan, you should also confirm with the plan directly that your doctor is in-network. While every plan on the marketplace must provide a link to its health provider directory, these lists may not be up-to-date. (45 C.F.R. § 156.230).

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