Your situation: You're planning to get care and use health insurance

This action plan applies to you if: 

• You're planning to get health care
• You'll use your health insurance to pay for your health care

 

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Action Plan

Confirm that the provider or facility is in your health plan’s network.

Using an in-network provider will save you money. Out-of-network providers are more expensive. And they might not be covered by your health plan.

Call your health plan or check their provider directory to find an in-network provider. You can find the directory on their website.

Sometimes, provider directories are out of date. Once you find a provider you’d like to use, double-check that they’re in-network. Call the provider’s office. Ask them if they're in your health insurance network.

Get care at an office or clinic instead of a hospital if possible.

Getting care in a hospital usually costs more than at a provider's office or clinic.

Learn about your rights under the No Surprises Act.

The No Surprises Act may apply to your medical billing issue. If it applies, you only have to pay your in-network copay or coinsurance and deductible.

In some situations, your provider can ask you to sign a notice and consent form to get out-of-network care. If you sign the form, you give up your protections from out-of-network unexpected bills.

Read about your rights under the No Surprises Act

Call your health care facility. Find out if any out-of-network providers will be involved in your care.

Sometimes you need to see more than one provider for a health care issue. In that situation, find out if any of those providers aren’t in your health plan’s network.

Ask for an estimate.

Ask your health care provider or facility for a cost estimate before you get care. They may be able to give you a rough idea of what your care will cost.